Provider Demographics
NPI:1669259347
Name:GET YOUR LIFE BACKS INC
Entity type:Organization
Organization Name:GET YOUR LIFE BACKS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROADWAY
Authorized Official - Suffix:
Authorized Official - Credentials:CASAC
Authorized Official - Phone:914-471-1055
Mailing Address - Street 1:217 NORTH AVE STE 801
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-6401
Mailing Address - Country:US
Mailing Address - Phone:914-471-1055
Mailing Address - Fax:914-633-1265
Practice Address - Street 1:217 NORTH AVE STE 801
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-6401
Practice Address - Country:US
Practice Address - Phone:914-471-1055
Practice Address - Fax:914-471-1055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No385HR2050XRespite Care FacilityRespite CareRespite Care Camp
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder