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Organization

UPLIFTING LIVES CLINIC OF ARIZONA, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHANNON CAROLYN PHILLIPS (OWNER/CLINICAL DIRECTOR)
(602) 670-6077
Entity
Organization

Contact information

Practice address
5150 N 99TH AVE, APT. 1097, GLENDALE, AZ 85305-3001
(602) 670-6077
Mailing address
5150 N 99TH AVE, APT. 1097, GLENDALE, AZ 85305-3001
(602) 670-6077

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
261QM0855X
Adolescent and Children Mental Health Clinic/Center
343900000X
Non-emergency Medical Transport (VAN)

Other

Enumeration date
03/13/2015
Last updated
03/13/2015
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