Provider Demographics
NPI:1851459317
Name:POSITIVE LIFE CENTER INC
Entity Type:Organization
Organization Name:POSITIVE LIFE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER VICE PRESIDENT SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:TEPE
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:708-848-0402
Mailing Address - Street 1:803 A NORTH HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302
Mailing Address - Country:US
Mailing Address - Phone:708-848-0400
Mailing Address - Fax:
Practice Address - Street 1:803 A NORTH HARLEM AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302
Practice Address - Country:US
Practice Address - Phone:708-848-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty