NPI: 1801016878
Provider Name: PROFESSIONAL PSYCHOLOGY ASSOCIATES, PC
Doing Business As: CENTER FOR LIFESTYLE CHANGE
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization
Specialization: Rehabilitation, Substance Use Disorder
CLIA Number: 03D2203247
Address:
4222 E CAMELBACK RD
SUITE H230
PHOENIX, AZ
ZIP 85018
Phone: (602) 852-0911
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PROFESSIONAL PSYCHOLOGY ASSOCIATES, PC is a rehabilitation and substance use disorder clinic center in Phoenix, AZ. PROFESSIONAL PSYCHOLOGY ASSOCIATES, PC NPI is 1801016878. The provider is registered as an organization entity type.
The provider Is Doing Business As Center For Lifestyle Change.
The provider's business location address is:
4222 E CAMELBACK RD
SUITE H230
PHOENIX, AZ
ZIP 85018-745
Phone: (602) 852-0911
Fax: (602) 852-0632
The provider's authorized official is Phillip D Lett .
The authorized official title is Administrator/president and has the following contact phone number (602) 852-0911.
The CLIA number assigned to this NPI record is 03D2203247 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 5/1/2007 and was last updated on 6/12/2008.