| Enriched Life Therapy Llc | |
|
617 Nw 36th Pl Cape Coral FL 33993-5568 | |
| (848) 219-0869 | |
| Not Available |
| Full Name | Enriched Life Therapy Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 617 Nw 36th Pl, Cape Coral, Florida |
| Authorized Official Name and Position | Lizhen Yan (OWNER) |
| Authorized Official Contact | 8482190869 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Enriched Life Therapy Llc 617 Nw 36th Pl Cape Coral FL 33993-5568 Ph: (848) 219-0869 | Enriched Life Therapy Llc 617 Nw 36th Pl Cape Coral FL 33993-5568 Ph: (848) 219-0869 |
| NPI Number | 1871132381 |
|---|---|
| Provider Enumeration Date | 12/31/2019 |
| Last Update Date | 12/20/2023 |
| Certification Date | 12/20/2023 |
| Medicare PECOS PAC ID | 0042662983 |
|---|---|
| Medicare Enrollment ID | O20240117000361 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871132381 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Lizhen Yan |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1255979688 PECOS PAC ID: 1951753896 Enrollment ID: I20240117000469 |
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