Provider Demographics
NPI:1295254472
Name:HEALTHY LIFESTYLES CONSULTANTS LLC
Entity type:Organization
Organization Name:HEALTHY LIFESTYLES CONSULTANTS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:GALAVIZ
Authorized Official - Suffix:
Authorized Official - Credentials:CMA LCMT
Authorized Official - Phone:702-481-8168
Mailing Address - Street 1:3128 S BRAND LEE WAY
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-5110
Mailing Address - Country:US
Mailing Address - Phone:702-481-8168
Mailing Address - Fax:
Practice Address - Street 1:3105 S 4TH AVE
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8122
Practice Address - Country:US
Practice Address - Phone:702-481-8168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QH0100X
AZ251E00000X, 261QR0400X, 305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No251E00000XAgenciesHome Health
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL707134OtherNATIONAL CERTIFICATION BOARD FOR THERAPEUTIC MASSAGE AND BODYWORK
AZMT-19507OtherARIZONA STATE BOARD OF MASSAGE THERAPY
CO339090OtherASSOCIATED BODYWORK & MASSAGE PROFESSIONALS
IL336580OtherAMERICAN ASSOCIATION OF MEDICAL ASSISTANTS