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Organization
LIFELINE PROFESSIONAL COUNSELING SERVICES, INC
Active
Organization
LIFELINE PROFESSIONAL COUNSELING SERVICES, INC
Active
Other names
Lifeline West
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DELORENZO (ADMINISTRATIVE DIRECTOR)
(480) 641-1165
Entity
Organization
Contact information
Practice address
17235 N 75TH AVE SUITE F-100, GLENDALE, AZ 85308
(480) 641-1165
Mailing address
17235 N 75TH AVE STE F100, GLENDALE, AZ 85308-0871
(480) 641-1165
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
BH4970
AZ
Other
Enumeration date
03/02/2018
Last updated
05/27/2020
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