Lifetorch Recovery Center & Wellness LLC
Clinic/Center, Rehabilitation, Substance Use Disorder in Ajo, AZ. Organization (NPI-2).
NPI number1104608751
StatusActive
Last updated in NPPESOct 18, 2023
Details
- NPI
- 1104608751
- Entity type
- Organization (NPI-2)
- Legal business name
- Lifetorch Recovery Center & Wellness LLC
- Organization subpart
- No
- Enumeration date
- Oct 18, 2023
- Certification date
- Oct 18, 2023
- Last updated
- Oct 18, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0405X | Clinic/Center, Rehabilitation, Substance Use Disorder | – | – | Yes |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – |
Practice location
1041 W Solana AveAjo, AZ 85321-2337
Phone 952-564-1263
Mailing address
423 N Creston Apt 260Mesa, AZ 85213-7085
Phone 952-564-1263
Authorized official
Emily Lagat
Owner
9525641263
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.