Organization
LIFE CHALLENGE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL G BERAM (PROGRAM COORDINATOR)
(602) 254-1995
Entity
Organization
Contact information
Practice address
341 W MCDOWELL RD, PHOENIX, AZ 85003-1214
(602) 254-1995
(602) 254-3123
Mailing address
341 W MCDOWELL RD, PHOENIX, AZ 85003-1214
(602) 254-1995
(602) 254-3123
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048836
—
AZ
Enumeration date
07/27/2021
Last updated
08/05/2021
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