Provider Demographics
NPI:1710109590
Name:GIFT OF LIFE COMPANY, INC.
Entity Type:Organization
Organization Name:GIFT OF LIFE COMPANY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:MAZUROWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:727-638-5709
Mailing Address - Street 1:3845 ERIN BROOK DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-2910
Mailing Address - Country:US
Mailing Address - Phone:727-422-5364
Mailing Address - Fax:
Practice Address - Street 1:4425 PARK BLVD
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3540
Practice Address - Country:US
Practice Address - Phone:727-547-0607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health