Provider Demographics
NPI:1205452117
Name:MD LIFE STRATEGIES, INC
Entity type:Organization
Organization Name:MD LIFE STRATEGIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:OBERLIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-917-2158
Mailing Address - Street 1:2820 S ALMA SCHOOL RD STE 18564
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-4392
Mailing Address - Country:US
Mailing Address - Phone:619-917-2158
Mailing Address - Fax:
Practice Address - Street 1:7435 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85207-8337
Practice Address - Country:US
Practice Address - Phone:619-917-2158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health