NPIMap

Organization Active NPI

Lifetorch Recovery Center & Wellness LLC

  • Rural Health Clinic/Center
  • Ajo, AZ
National Provider Identifier
1760101794
Registry record updated Nov 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
LIFETORCH RECOVERY CENTER & WELLNESS LLC
Practice address
1041 W Solana Ave
Ajo, AZ 85321-2337
Phone
(952) 564-1263
NPI assigned
Aug 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2022

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

Authorized official

Name
Emily Lagat
Title
Owner
Phone
(952) 564-1263

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1041 W Solana Ave
Ajo, AZ 85321-2337

Mailing address

423 N Creston Apt 260
Mesa, AZ 85213-7085
Phone (952) 564-1263

National Provider Directory

National Provider Directory
Tax ID family
Lifetorch Recovery Center Wellness LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1041 W Solana Ave
Ajo, AZ 85321
Phone (480) 690-5210

NPI Registry JSON

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669420800000",
    "number": "1760101794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 N CRESTON APT 260",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852137085",
            "telephone_number": "952-564-1263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 W SOLANA AVE",
            "city": "AJO",
            "state": "AZ",
            "postal_code": "853212337",
            "telephone_number": "952-564-1263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETORCH RECOVERY CENTER & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-11-26",
        "certification_date": "2022-11-26",
        "status": "A",
        "authorized_official_last_name": "LAGAT",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-564-1263"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ajo, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2022; 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.