Provider Demographics
NPI:1972268167
Name:BRITELIFE RECOVERY AT HANOVER LLC
Entity Type:Organization
Organization Name:BRITELIFE RECOVERY AT HANOVER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TUVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-622-3605
Mailing Address - Street 1:180 SYLVAN AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2519
Mailing Address - Country:US
Mailing Address - Phone:347-622-3605
Mailing Address - Fax:843-869-8041
Practice Address - Street 1:544 IRON RIDGE RD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-6838
Practice Address - Country:US
Practice Address - Phone:843-869-8040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility