| A Head Of Life Behavior Health Services Llc | |
|
2021 W Washington St Apt 5b Phoenix AZ 85009-5271 | |
| (725) 724-6681 | |
| Not Available |
| Full Name | A Head Of Life Behavior Health Services Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 2021 W Washington St Apt 5b, Phoenix, Arizona |
| Authorized Official Name and Position | Jacqueline Dennise Lucious (OWNER) |
| Authorized Official Contact | 7257246681 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| A Head Of Life Behavior Health Services Llc 2021 W Washington St Apt 5b Phoenix AZ 85009-5271 Ph: (725) 724-6681 | A Head Of Life Behavior Health Services Llc 2021 W Washington St Apt 5b Phoenix AZ 85009-5271 Ph: (725) 724-6681 |
| NPI Number | 1306518287 |
|---|---|
| Provider Enumeration Date | 09/29/2021 |
| Last Update Date | 09/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306518287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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