Provider Demographics
NPI:1750806238
Name:LIVE YOUR BEST LIFE LLC
Entity type:Organization
Organization Name:LIVE YOUR BEST LIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ECKE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-618-6000
Mailing Address - Street 1:1306 MOUNT MISERY RD
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-4103
Mailing Address - Country:US
Mailing Address - Phone:609-618-6000
Mailing Address - Fax:
Practice Address - Street 1:1201 ROUTE 37 E STE 2
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-5728
Practice Address - Country:US
Practice Address - Phone:609-618-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-07
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)