Organization
KHALIL LIFE SERVICES LLC
Active
Organization
KHALIL LIFE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CERMILLIA WILLIAMS MSW, MBA (CEO)
(314) 494-7603
Entity
Organization
Contact information
Practice address
2655 W GUADALUPE RD STE 7, MESA, AZ 85202-7246
(602) 860-2354
Mailing address
2655 W GUADALUPE RD STE 7, MESA, AZ 85202-7246
(602) 860-2354
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
05/31/2024
Last updated
11/16/2024
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