Organization
GIFTED LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STARLA JACKSON (PROVIDER)
(602) 799-3597
Entity
Organization
Contact information
Practice address
610 E PIEDMONT RD, PHOENIX, AZ 85042-8419
(602) 799-3597
Mailing address
610 E PIEDMONT RD, PHOENIX, AZ 85042-8419
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
342000000X
Transportation Network Company
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
04/06/2026
Last updated
04/06/2026
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