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General NPI Number Information
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NPI Number | 1245616531
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Entity Type | Organization
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Legal Business Name | LIFEWORKS RECOVERY
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Dates
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Enumeration Date | 08/10/2015
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Last Update Date | 08/10/2015
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Provider Practice Location Address
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Address Line | 14651 DALLAS PKWY STE 106
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City | DALLAS
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State | TX
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Zip | 75254-8899
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Country | US
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Telephone | 972-313-5742
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Fax |
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Provider Business Mailing Address
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Address Line | 14651 DALLAS PKWY STE 106
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City | DALLAS
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State | TX
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Zip | 75254-8899
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Country | US
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Telephone | 972-313-5742
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRIS THOMAS LORENC
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Credential | LPC
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Telephone | 972-313-5742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 62073
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License Number State | TX
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