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General NPI Number Information
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NPI Number | 1316637986
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Entity Type | Organization
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Legal Business Name | ONE STOP LIFE CENTER
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Dates
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Enumeration Date | 05/08/2023
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Last Update Date | 05/08/2023
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Provider Practice Location Address
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Address Line | 2219 S 48TH ST STE I&J
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City | TEMPE
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State | AZ
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Zip | 85282-1010
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Country | US
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Telephone | 602-348-8249
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Fax |
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Provider Business Mailing Address
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Address Line | 2219 S 48TH ST STE I&J
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City | TEMPE
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State | AZ
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Zip | 85282-1010
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Country | US
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Telephone | 602-348-8249
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DEBRA J. GARRETT
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Credential |
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Telephone | 602-348-8249
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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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 | 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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