| NPI | 1720580038 |
|---|---|
| Doing Business As | LIFELINE WEST |
| Entity Type | Organization |
| Authorized Contact | JOHN DELORENZO Administrative Director 480-641-1165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: AZ BH4970) |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2020-05-27 |