| For Life Services-community Care, Llc | |
|
16671 N Litchfield Rd Apt 223 Surprise AZ 85374-7080 | |
| (602) 405-4962 | |
| (702) 973-6392 |
| Full Name | For Life Services-community Care, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 16671 N Litchfield Rd Apt 223, Surprise, Arizona |
| Authorized Official Name and Position | Tra Ahia (CEO) |
| Authorized Official Contact | 6024054962 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| For Life Services-community Care, Llc Po Box 8222 Surprise AZ 85374-0120 Ph: (602) 405-4962 | For Life Services-community Care, Llc 16671 N Litchfield Rd Apt 223 Surprise AZ 85374-7080 Ph: (602) 405-4962 |
| NPI Number | 1689719650 |
|---|---|
| Provider Enumeration Date | 02/20/2007 |
| Last Update Date | 03/14/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689719650 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | BH 2690 (Arizona) | Primary |
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