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General NPI Number Information
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NPI Number | 1215538806
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Entity Type | Organization
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Legal Business Name | LIFE N LOVE WELLNESS INC
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Dates
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Enumeration Date | 11/02/2020
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 4801 S LAKESHORE DR STE 101
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City | TEMPE
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State | AZ
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Zip | 85282-7156
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Country | US
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Telephone | 480-594-3570
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Fax |
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Provider Business Mailing Address
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Address Line | 4050 E COTTON CENTER BLVD STE 77
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City | PHOENIX
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State | AZ
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Zip | 85040-8865
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Country | US
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Telephone | 480-594-3570
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOSHUA FARRAKHAN
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Credential |
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Telephone | 480-594-3570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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