Organization
LIFEGATE HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA MENSAH RN, MSN (OWNER)
(623) 419-4970
Entity
Organization
Contact information
Practice address
15453 W MADISON ST, GOODYEAR, AZ 85338-3397
(602) 419-4970
Mailing address
17148 W BUCHANAN ST, GOODYEAR, AZ 85338-1285
(602) 419-4970
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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