Organization
PERSONAL RECOVERY NETWORK LLC
Active
Other names
LifeStance Health
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN PARDO (LEGAL CHIEF OFFICER)
(206) 399-1493
Entity
Organization
Contact information
Practice address
250 CORPORATE CENTER CT, STOCKBRIDGE, GA 30281
(770) 389-8100
(770) 389-3030
Mailing address
4800 N SCOTTSDALE RD STE 2500, SCOTTSDALE, AZ 85251-7630
(253) 346-0392
(770) 389-3030
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
261QA0005X
Ambulatory Family Planning Facility
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
02/08/2011
Last updated
01/18/2025
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