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General NPI Number Information
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NPI Number | 1023413549
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Entity Type | Organization
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Legal Business Name | A TRUE LIFE SOMERSET,LLC
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Dates
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Enumeration Date | 10/27/2014
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Last Update Date | 10/27/2014
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Provider Practice Location Address
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Address Line | 100 FRANKLIN SQUARE DR SUITE 207
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City | SOMERSET
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State | NJ
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Zip | 08873-4109
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Country | US
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Telephone | 606-346-0509
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Fax | 888-261-3082
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Provider Business Mailing Address
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Address Line | 100 FRANKLIN SQUARE DR SUITE 207
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City | SOMERSET
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State | NJ
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Zip | 08873-4109
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Country | US
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Telephone | 606-346-0509
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Fax | 888-261-3082
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Authorized Official
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Title or Position | CEO
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Name | MR. RAJAT RUSTAGI
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Credential |
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Telephone | 908-967-5559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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