Provider Demographics
NPI:1972756138
Name:LIFE FORCE HYPNOSIS, LLC
Entity Type:Organization
Organization Name:LIFE FORCE HYPNOSIS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:CLARKE
Authorized Official - Last Name:MCCORMACK
Authorized Official - Suffix:
Authorized Official - Credentials:LCDP
Authorized Official - Phone:401-737-4685
Mailing Address - Street 1:1845 POST RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1543
Mailing Address - Country:US
Mailing Address - Phone:401-737-4685
Mailing Address - Fax:401-737-4685
Practice Address - Street 1:1845 POST RD
Practice Address - Street 2:SUITE 10
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1543
Practice Address - Country:US
Practice Address - Phone:401-737-4685
Practice Address - Fax:401-737-4685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-30
Last Update Date:2008-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILCDP00439302F00000X, 305R00000X, 305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
No302F00000XManaged Care OrganizationsExclusive Provider Organization
No305R00000XManaged Care OrganizationsPreferred Provider Organization