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Organization
LUZ Y VIDA, INC.
Active
Organization
LUZ Y VIDA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSA ASILIS (CEO)
(267) 275-6617
Entity
Organization
Contact information
Practice address
120 W WYOMING AVE, PHILADELPHIA, PA 19140-1629
(267) 275-6617
Mailing address
120 W WYOMING AVE, PHILADELPHIA, PA 19140-1629
(267) 275-6617
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
PA
Other
Enumeration date
06/09/2016
Last updated
06/09/2016
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