| Lifemor Inc. | |
|
875 S Estrella Pkwy Unit 6573 Goodyear AZ 85338-8563 | |
| (480) 370-0227 | |
| (505) 814-5740 |
| Full Name | Lifemor Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 875 S Estrella Pkwy Unit 6573, Goodyear, Arizona |
| Authorized Official Name and Position | Robert Grant Gates (PRESIDENT) |
| Authorized Official Contact | 4803700227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifemor Inc. 875 S Estrella Pkwy Unit 6573 Goodyear AZ 85338-8563 Ph: (480) 370-0227 | Lifemor Inc. 875 S Estrella Pkwy Unit 6573 Goodyear AZ 85338-8563 Ph: (480) 370-0227 |
| NPI Number | 1710224779 |
|---|---|
| Provider Enumeration Date | 01/10/2013 |
| Last Update Date | 12/18/2023 |
| Certification Date | 12/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710224779 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 0083441 (New Mexico) | Primary |
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