Organization
LIFES JOURNEY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICARDO RAMOS (GROUP HOME MANAGER)
(609) 462-9952
Entity
Organization
Contact information
Practice address
7591 N 85TH DR, GLENDALE, AZ 85305-3982
(609) 462-9952
Mailing address
7591 N 85TH DR, GLENDALE, AZ 85305-3982
(609) 462-9952
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
PROCESS OF ACQUIRING OTHER IDENTIFIER
—
Enumeration date
10/20/2020
Last updated
10/20/2020
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