Healthcare Provider Details
I. General information
NPI: 1316121213
Provider Name (Legal Business Name): UNIQUE LIFE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/27/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1994 HUGHES AVE
BRONX NY
10457-4902
US
IV. Provider business mailing address
1994 HUGES AVE
BRONX NY
10457
US
V. Phone/Fax
- Phone: 347-449-7891
- Fax: 347-449-7888
- Phone: 347-449-7891
- Fax: 347-449-7888
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | NY |
VIII. Authorized Official
Name: DR.
AKWASI
ACHAMPONG
Title or Position: EXECUTIVE DIRECTOR
Credential: M.D
Phone: 347-449-7891