Organization
GREATER NEW LIFE WORSHIP CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACEY DENISE DAVIS (EXECUTIVE DIRECTOR/OFFICE /MANAGER)
(803) 293-5149
Entity
Organization
Contact information
Practice address
2450 W GLENROSA AVE UNIT 24, PHOENIX, AZ 85015-4989
(803) 293-5149
Mailing address
2450 W GLENROSA AVE UNIT 24, PHOENIX, AZ 85015-4989
(803) 293-5149
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/10/2022
Last updated
10/10/2022
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