For Life Services-Community Care, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

BH 2690 Issued in AZ

Legal business name

FOR LIFE SERVICES-COMMUNITY CARE, LLC

Practice address

16671 N Litchfield Rd Apt 223
Surprise, AZ 85374-7080

Phone

(602) 405-4962

Fax

(702) 973-6392

NPI assigned

Feb 20, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tra Ahia, PH. D.

Title

Ceo

Phone

(602) 405-4962

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363219200000",
    "number": "1689719650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8222",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853740120",
            "telephone_number": "602-405-4962",
            "fax_number": "702-973-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16671 N LITCHFIELD RD APT 223",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747080",
            "telephone_number": "602-405-4962",
            "fax_number": "702-973-6392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOR LIFE SERVICES-COMMUNITY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2013-03-14",
        "status": "A",
        "authorized_official_last_name": "AHIA",
        "authorized_official_first_name": "TRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-405-4962",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH. D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH 2690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.