MEDICARE: FORWARD IN LIFE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1952904179
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORWARD IN LIFE LLC

Provider Business Mailing Address
First Line	:	8402 N 33RD DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85051-5916
Country	:	US
Telephone Number	:	480-404-4159
Fax Number	:

Provider Business Practice Location Address
First Line	:	8402 N 33RD DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85051-5916
Country	:	US
Telephone Number	:	480-404-4159
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MELISSA NASH
Credential	:
Telephone Number	:	480-404-4159

Provider Enumeration Date	:	11/19/2020
Last Update Date	:	09/02/2025

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Directions to “FORWARD IN LIFE LLC ” Practice Location

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