Organization
FOR LIFE SERVICES-COMMUNITY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRA AHIA PH. D. (CEO)
(602) 405-4962
Entity
Organization
Contact information
Practice address
16671 N LITCHFIELD RD APT 223, SURPRISE, AZ 85374-7080
(602) 405-4962
(702) 973-6392
Mailing address
PO BOX 8222, SURPRISE, AZ 85374-0120
(602) 405-4962
(702) 973-6392
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH 2690
AZ
Other
Enumeration date
02/20/2007
Last updated
03/14/2013
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