# GREATER NEW LIFE WORSHIP CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326763574
- **Authorized official:** MRS. TRACEY DENISE DAVIS (EXECUTIVE DIRECTOR/OFFICE /MANAGER)
- **Authorized official phone:** (803) 293-5149

## Contact information

- **Practice address:** 2450 W GLENROSA AVE UNIT 24, PHOENIX, AZ 85015-4989
- **Practice address phone:** (803) 293-5149
- **Mailing address:** 2450 W GLENROSA AVE UNIT 24, PHOENIX, AZ 85015-4989
- **Mailing address phone:** (803) 293-5149

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 10/10/2022
- **Last updated:** 10/10/2022