Organization
LIFEFORCE RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHADIJAT QUADRI LPC (PRESIDENT)
(210) 314-7687
Entity
Organization
Contact information
Practice address
4100 E PIEDRAS DR, SUITE 262, SAN ANTONIO, TX 78228-1401
(210) 314-7687
(210) 314-7494
Mailing address
4100 E PIEDRAS DR, SUITE 262, SAN ANTONIO, TX 78228-1401
(210) 314-7687
(210) 314-7494
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
67102
TX
3245S0500X
Children's Substance Abuse Rehabilitation Facility
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Other
Enumeration date
11/09/2015
Last updated
11/09/2015
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