Provider Demographics
NPI:1922781772
Name:LIZ HENRIQUES LLC
Entity Type:Organization
Organization Name:LIZ HENRIQUES LLC
Other - Org Name:GLORIA HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELISABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRIQUES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:631-241-3073
Mailing Address - Street 1:410 MAYTIDE ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-1848
Mailing Address - Country:US
Mailing Address - Phone:631-241-3073
Mailing Address - Fax:
Practice Address - Street 1:311 S CRAIG ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3734
Practice Address - Country:US
Practice Address - Phone:631-241-3073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-09
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)