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Organization

LIFE TRANSFORMATION RECOVERY

Active
Parent organization
LIFE TRANSFORMATION RECOVERY
Organization subpart
Yes

Provider details

NPI number
Legal business name
LIFE TRANSFORMATION RECOVERY
Authorized official
DAVID SANCHEZ RN (EXECUTIVE DIRECTOR)
(928) 515-0044
Entity
Organization

Contact information

Practice address
6217 N REATA DR, PRESCOTT VALLEY, AZ 86314-3234
(928) 515-0044
(928) 433-4977
Mailing address
8521 E FLORENTINE RD STE B, PRESCOTT VALLEY, AZ 86314-8954
(928) 515-0044

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
BH4673
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
083523
AZ
Enumeration date
05/24/2016
Last updated
10/27/2016
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