Organization
LIFEMOR INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT GRANT GATES M.A. LPCC. DMIN (PRESIDENT)
(480) 370-0227
Entity
Organization
Contact information
Practice address
875 S ESTRELLA PKWY UNIT 6573, GOODYEAR, AZ 85338-8563
(480) 370-0227
(505) 814-5740
Mailing address
875 S ESTRELLA PKWY UNIT 6573, GOODYEAR, AZ 85338-8563
(480) 370-0227
(505) 814-5740
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0083441
NM
Other
Enumeration date
01/10/2013
Last updated
12/18/2023
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