Organization
ENGAGING LIFE INTEGRATED WELLNESS CENTER
Active
Parent organization
ENGAGING LIFE CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
ENGAGING LIFE CENTER
Authorized official
HENRY MERCADO (CFO)
(602) 845-0767
Entity
Organization
Contact information
Practice address
12600 N. 13TH AVENUE, SUITE B8, YOUNGTOWN, AZ 85363
(602) 845-0767
(602) 715-0647
Mailing address
12600 N. 13TH AVENUE, SUITE B8, YOUNGTOWN, AZ 85363
(602) 845-0767
(602) 715-0647
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000001
NO NUMBER OBTAINED
—
Enumeration date
02/18/2021
Last updated
02/18/2021
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