Organization
A HEAD OF LIFE BEHAVIOR HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELINE DENNISE LUCIOUS (OWNER)
(725) 724-6681
Entity
Organization
Contact information
Practice address
2021 W WASHINGTON ST APT 5B, PHOENIX, AZ 85009-5271
(725) 724-6681
Mailing address
2021 W WASHINGTON ST APT 5B, PHOENIX, AZ 85009-5271
(725) 724-6681
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/29/2021
Last updated
09/29/2021
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