Provider Demographics
NPI:1063094068
Name:FRIENDS FOR LIFE CENTER
Entity type:Organization
Organization Name:FRIENDS FOR LIFE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:FAIVISH
Authorized Official - Middle Name:
Authorized Official - Last Name:DENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:RABBI
Authorized Official - Phone:786-269-7837
Mailing Address - Street 1:1580 79TH STREET CSWY
Mailing Address - Street 2:
Mailing Address - City:NORTH BAY VILLAGE
Mailing Address - State:FL
Mailing Address - Zip Code:33141-4131
Mailing Address - Country:US
Mailing Address - Phone:786-535-7605
Mailing Address - Fax:786-535-7336
Practice Address - Street 1:1580 79TH STREET CSWY
Practice Address - Street 2:
Practice Address - City:NORTH BAY VILLAGE
Practice Address - State:FL
Practice Address - Zip Code:33141-4131
Practice Address - Country:US
Practice Address - Phone:786-535-7605
Practice Address - Fax:786-535-7336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services