# KELLERLIFE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** KellerLife Center for Eating Disorders
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962998161
- **Authorized official:** TODD BRIAN TAYLOR MD (CLINICAL INFORMATICIST)
- **Authorized official phone:** (480) 294-1386

## Contact information

- **Practice address:** 111 S HEARTHSTONE WAY, CHANDLER, AZ 85226-5010
- **Practice address phone:** (480) 239-3459
- **Mailing address:** 111 S HEARTHSTONE WAY, CHANDLER, AZ 85226-5010
- **Mailing address phone:** (480) 656-1070
- **Mailing address fax:** (480) 656-1231

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 07/11/2018
- **Last updated:** 10/26/2018