MEDICARE: LIFETOUCH BEHAVIORAL HEALTH, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1942700125
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFETOUCH BEHAVIORAL HEALTH, LLC

Provider Business Mailing Address
First Line	:	28 PIONEER CT
Second Line	:
City	:	EWING
State	:	NJ
Zip	:	08628-3604
Country	:	US
Telephone Number	:	732-514-2150
Fax Number	:

Provider Business Practice Location Address
First Line	:	28 PIONEER CT
Second Line	:
City	:	EWING
State	:	NJ
Zip	:	08628-3604
Country	:	US
Telephone Number	:	732-514-2150
Fax Number	:	732-960-2323

Authorized Official
Title or Position	:	OWNER/DNP
Name	:	IJEOMA OKEKE
Credential	:
Telephone Number	:	732-514-2150

Provider Enumeration Date	:	02/14/2018
Last Update Date	:	12/06/2021

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