Free Life Wellness Center Llc

LBN: Free Life Wellness Center Llc
Free Life Wellness Center Llc is an health care organization with primary practice located at 1731 W Baseline Rd Ste 113 , Mesa AZ 85202-5782. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Agencies / Community/Behavioral Health. Agencies / Community/Behavioral Health is the primary health care specialty. Free Life Wellness Center Llc can be contacted via phone (480) 687-1773, or through Gooch, Courtney Starr via phone (480) 687-1773.

Contact Information

Primary practice address
1731 W Baseline Rd Ste 113 Mesa AZ 85202-5782
Phone: (480) 687-1773
Fax: (480) 687-2986
Website:
Map and Directions
Authorized official contact:
Name: Gooch, Courtney Starr
Phone: (480) 687-1773

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Agencies / Community/Behavioral Health 251S00000X

Profile Details

NPI number 1316539687
LBN Legal business name Free Life Wellness Center Llc
DBA Doing business as
Authorized official Gooch, Courtney Starr
Entity Organization
Organization subpart 1 No
Enumeration date Feb 9th, 2021
Last updated Oct 17th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316539687 NPPES
Arizona MEDICAID 100618

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