| Lifegate Health Services Llc | |
|
15453 W Madison St Goodyear AZ 85338-3397 | |
| (602) 419-4970 | |
| Not Available |
| Full Name | Lifegate Health Services Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 15453 W Madison St, Goodyear, Arizona |
| Authorized Official Name and Position | Regina Mensah (OWNER) |
| Authorized Official Contact | 6234194970 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifegate Health Services Llc 17148 W Buchanan St Goodyear AZ 85338-1285 Ph: (602) 419-4970 | Lifegate Health Services Llc 15453 W Madison St Goodyear AZ 85338-3397 Ph: (602) 419-4970 |
| NPI Number | 1720846041 |
|---|---|
| Provider Enumeration Date | 03/11/2024 |
| Last Update Date | 03/11/2024 |
| Certification Date | 03/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720846041 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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