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General NPI Number Information
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NPI Number | 1639830458
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Entity Type | Organization
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Legal Business Name | LIFFEY HEALTH
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Dates
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Enumeration Date | 01/04/2022
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Last Update Date | 04/28/2022
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Provider Practice Location Address
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Address Line | 1171 HOMESTEAD RD STE 295
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City | SANTA CLARA
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State | CA
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Zip | 95050-5486
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Country | US
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Telephone | 510-468-0732
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Fax |
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Provider Business Mailing Address
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Address Line | 1171 HOMESTEAD RD STE 295
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City | SANTA CLARA
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State | CA
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Zip | 95050-5486
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Country | US
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Telephone | 669-201-4949
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | SEAN PATRICK SINGH DYAL
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Credential |
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Telephone | 669-201-4949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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