| Lifeline Pcs -southeast | |
|
7565 E Eagle Crest Dr Ste 101 Mesa AZ 85207-1041 | |
| (480) 641-1165 | |
| (480) 641-9026 |
| Full Name | Lifeline Pcs -southeast |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 7565 E Eagle Crest Dr Ste 101, Mesa, Arizona |
| Authorized Official Name and Position | Roxanne Dalpos (PRESIDENT) |
| Authorized Official Contact | 4802038414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifeline Pcs -southeast 335 N Alma School Rd Ste E Chandler AZ 85224-4363 Ph: (817) 965-5908 | Lifeline Pcs -southeast 7565 E Eagle Crest Dr Ste 101 Mesa AZ 85207-1041 Ph: (480) 641-1165 |
| NPI Number | 1023726866 |
|---|---|
| Provider Enumeration Date | 11/10/2022 |
| Last Update Date | 11/16/2022 |
| Certification Date | 11/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023726866 | NPI | - | NPPES |
| BH8238 | Medicaid | AZ |
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