Life Care Premier Services LLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Surprise, AZ. Organization (NPI-2).
NPI number1164039723
StatusActive
Last updated in NPPESMar 15, 2021
Details
- NPI
- 1164039723
- Entity type
- Organization (NPI-2)
- Legal business name
- Life Care Premier Services LLC
- Organization subpart
- No
- Enumeration date
- Sep 28, 2020
- Certification date
- Mar 15, 2021
- Last updated
- Mar 15, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Practice location
16400 N 138th LnSurprise, AZ 85374-7031
Phone 773-606-7222
Mailing address
4690 S Lakeshore Dr Apt 3052Tempe, AZ 85282-1174
Authorized official
Abby Richardson
Health Care
7736067222
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