Provider Demographics
NPI:1164289088
Name:VALLEY LIFE SOLUTIONS LLC
Entity Type:Organization
Organization Name:VALLEY LIFE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELTAYEB
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-599-9517
Mailing Address - Street 1:6127 W WAGONER RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-1150
Mailing Address - Country:US
Mailing Address - Phone:480-599-9517
Mailing Address - Fax:
Practice Address - Street 1:4480 W PEORIA AVE STE 106&107
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-2038
Practice Address - Country:US
Practice Address - Phone:480-599-9517
Practice Address - Fax:602-860-6171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)