Provider Demographics
NPI:1932906856
Name:MORE LIFE WELLNESS LLC
Entity type:Organization
Organization Name:MORE LIFE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:NORDEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-622-6163
Mailing Address - Street 1:1107 E GLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-5316
Mailing Address - Country:US
Mailing Address - Phone:480-606-8602
Mailing Address - Fax:
Practice Address - Street 1:1107 E GLENDALE AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5316
Practice Address - Country:US
Practice Address - Phone:602-622-6163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1548034226
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-27
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility