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General NPI Number Information
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NPI Number | 1881001881
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Entity Type | Organization
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Legal Business Name | FRIENDS 4 LIFE LLC
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Dates
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Enumeration Date | 07/22/2014
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 650 SUFFIELD STREET
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City | AGAWAM
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State | MA
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Zip | 01001
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Country | US
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Telephone | 413-214-1940
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Fax |
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Provider Business Mailing Address
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Address Line | 4 CONCORDE WAY A4
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City | WINDSOR LOCKS
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State | CT
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Zip | 06069
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Country | US
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Telephone | 860-712-4387
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. MUHAMMAD NAVEED IMTIAZ
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Credential |
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Telephone | 860-712-4387
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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