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Organization
LIFE CENTER ORGANIZATION
Active
Organization
LIFE CENTER ORGANIZATION
Active
Other names
Life Center Organization
Organization subpart
No
Provider details
NPI number
Authorized official
DUSTY HARRYMAN (PRESIDENT/FOUNDER)
(620) 875-6604
Entity
Organization
Contact information
Practice address
122 W WASHINGTON ST, PITTSBURG, KS 66762-5153
(620) 875-6604
Mailing address
122 W WASHINGTON ST, PITTSBURG, KS 66762-5153
(620) 875-6604
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/06/2024
Last updated
06/06/2024
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