Provider Demographics
NPI:1740449446
Name:LIFEFORCE FAMILY WELLNESS CENTER, INC.
Entity type:Organization
Organization Name:LIFEFORCE FAMILY WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:805-375-2801
Mailing Address - Street 1:1000 NEWBURY RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91320-6435
Mailing Address - Country:US
Mailing Address - Phone:805-375-2801
Mailing Address - Fax:805-375-2802
Practice Address - Street 1:1000 NEWBURY RD
Practice Address - Street 2:SUITE 230
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91320-6435
Practice Address - Country:US
Practice Address - Phone:805-375-2801
Practice Address - Fax:805-375-2802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center