Lifeline Professional Counseling Services, INC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Mesa, AZ. Organization (NPI-2).
NPI number1194285643
StatusActive
Last updated in NPPESMay 27, 2020
Details
- NPI
- 1194285643
- Entity type
- Organization (NPI-2)
- Legal business name
- Lifeline Professional Counseling Services, INC
- Organization subpart
- Yes
- Enumeration date
- Mar 21, 2019
- Certification date
- May 27, 2020
- Last updated
- May 27, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Other names
- Lifeline East (Doing Business As)
Practice location
1423 S Higley Rd Ste 103Mesa, AZ 85206-3449
Phone 480-641-1165 · Fax 480-641-9026
Mailing address
335 N Alma School Rd Ste EChandler, AZ 85224-4363
Phone 480-641-1165 · Fax 480-641-9026
Authorized official
John Delorenzo
Cfo
4806411165
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