Organization
AWAKE FOR LIFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY GERLACH LCSW (OWNER)
(928) 707-1841
Entity
Organization
Contact information
Practice address
143 N MCCORMICK ST STE 103, PRESCOTT, AZ 86301-2725
(928) 707-1841
Mailing address
143 N MCCORMICK ST STE 103, PRESCOTT, AZ 86301-2725
(928) 707-1841
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/24/2023
Last updated
05/24/2023
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