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General NPI Number Information
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NPI Number | 1659613784
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Entity Type | Organization
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Legal Business Name | LIFE OF PURPOSE, LLC
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Dates
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Enumeration Date | 03/27/2013
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Last Update Date | 03/27/2013
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Provider Practice Location Address
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Address Line | 3848 FAU BLVD STE 100 INNOVATION CENTER 2
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City | BOCA RATON
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State | FL
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Zip | 33431-6437
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Country | US
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Telephone | 561-299-3769
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 811503
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City | BOCA RATON
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State | FL
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Zip | 33481-1503
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | SARAH LUCAS
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Credential |
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Telephone | 617-894-5156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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