| Victorious Lifestyle Llc | |
|
10000 N 31st Ave Ste C307 Phoenix AZ 85051-9569 | |
| (240) 397-0554 | |
| Not Available |
| Full Name | Victorious Lifestyle Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 10000 N 31st Ave Ste C307, Phoenix, Arizona |
| Authorized Official Name and Position | Shareka Sherrod (OWNER) |
| Authorized Official Contact | 2403970554 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Victorious Lifestyle Llc 1831 E Apache Blvd Apt 2098 Tempe AZ 85281-6682 Ph: () - | Victorious Lifestyle Llc 10000 N 31st Ave Ste C307 Phoenix AZ 85051-9569 Ph: (240) 397-0554 |
| NPI Number | 1457069338 |
|---|---|
| Provider Enumeration Date | 11/09/2022 |
| Last Update Date | 11/09/2022 |
| Certification Date | 11/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457069338 | NPI | - | NPPES |
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