| NPI | 1821003419 |
|---|---|
| Other Name | CENTER FOR LIFESTYLE CHANGE |
| Entity Type | Organization |
| Authorized Contact | PHILLIP D LETT Administrator 602-852-0911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TR0400X Psychologist Rehabilitation (Licence: AZ BH934) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2020-08-22 |