Provider Demographics
NPI:1881001881
Name:FRIENDS 4 LIFE LLC
Entity Type:Organization
Organization Name:FRIENDS 4 LIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:NAVEED
Authorized Official - Last Name:IMTIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-712-4387
Mailing Address - Street 1:4 CONCORDE WAY A4
Mailing Address - Street 2:
Mailing Address - City:WINDSOR LOCKS
Mailing Address - State:CT
Mailing Address - Zip Code:06069
Mailing Address - Country:US
Mailing Address - Phone:860-712-4387
Mailing Address - Fax:
Practice Address - Street 1:650 SUFFIELD STREET
Practice Address - Street 2:
Practice Address - City:AGAWAM
Practice Address - State:MA
Practice Address - Zip Code:01001
Practice Address - Country:US
Practice Address - Phone:413-214-1940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRIENDS 4 LIFE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-22
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health