| NPI | 1609496488 |
|---|---|
| Doing Business As | LIFES SECOND CHANCE TREATMENT CENTER NORTH |
| Entity Type | Organization |
| Authorized Contact | LAKISHA HENDERSON Owner 469-360-6794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2020-04-21 |