LIFEWELL BEHAVIORAL WELLNESS (NPI# 1609251057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609251057 |
| Entity Type | Organization |
| Organization Name | LIFEWELL BEHAVIORAL WELLNESS |
| Practice Address |
3540 E Baseline Rd Suite 150 Phoenix AZ 85042-9630 |
| Mailing Address |
202 E Earll Dr Suite 200 Phoenix AZ 85012-2634 |
| Practice Telephone | 6028082800 |
| Practice Fax Number | 6028082799 |
| Mailing Telephone | 6028082800 |
| Mailing Fax Number | 6028082799 |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2016-11-04 |
| Authorized Official Name | DORIS VAUGHT (ECECUTIVE VICE PRESIDENT/CFO) |
| Authorized Official Telephone | 6025995420 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | OTC7810 | AZ | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 037445 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720330194 | Lifewell Behavioral Wellness | Community/Behavioral Health | 6915 E. Main Street, Mesa, AZ 85207-8201 | 2012-10-10 |
| 1386939247 | Lifewell Behavioral Wellness | Community/Behavioral Health | 262 E. University Drive, Mesa, AZ 85201-5932 | 2011-06-17 |
| 1255547444 | Lifewell Behavioral Wellness | Voluntary or Charitable | 119 W. Highland Avenue, Phoenix, AZ 85013-4707 | 2007-05-15 |
| 1306928932 | Lifewell Behavioral Wellness | Substance Abuse Rehabilitation Facility | 3301 E Pinchot Ave, Phoenix, AZ 85018-6807 | 2006-10-20 |
| 1497837025 | Lifewell Behavioral Wellness | Community Based Residential Treatment Facility, Mental Illness | 619 W Southern Ave, Mesa, AZ 85210-5004 | 2006-10-20 |
| 1154401156 | Lifewell Behavioral Wellness | Community Based Residential Treatment Facility, Mental Illness | 3222 N 37th St, Phoenix, AZ 85018-6304 | 2006-10-16 |
| 1801976709 | Lifewell Behavioral Wellness | Community Based Residential Treatment Facility, Mental Illness | 621 W Southern Ave, Mesa, AZ 85210-5004 | 2006-10-16 |
| 1982191284 | Lifewell Behavioral Wellness | Community/Behavioral Health | 2311 W Royal Palm Rd, Phoenix, AZ 85021 | 2018-04-23 |
| 1255716601 | Lifewell Behavioral Wellness | Community/Behavioral Health | 2715 N 3rd St, Phoenix, AZ 85004-1106 | 2015-07-28 |
| 1790160141 | Lifewell Behavioral Wellness | Community/Behavioral Health | 4451 E Oak St, Phoenix, AZ 85008-2410 | 2015-07-28 |
| Street Address |
3540 E BASELINE RD SUITE 150 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85042-9630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134322498 | Harris Khan Khakwani | Family Medicine | 3540 E Baseline Rd, 130, Phoenix, AZ 85042-9627 | 2007-06-06 |
| 1699132597 | Valerie Ann Palacios-chapa | Nurse Practitioner | 3540 E Baseline Rd, Suite 131, Phoenix, AZ 85042-9627 | 2016-01-22 |
| 1356731418 | Delana Prosperie Brown | Nurse Practitioner | 3540 E Baseline Rd, Suite 131, Phoenix, AZ 85042-9627 | 2015-01-28 |
| 1619301330 | Akdhc, LLC | Internal Medicine | 3540 E Baseline Rd, Suite 130, Phoenix, AZ 85042-9627 | 2013-08-29 |
| 1629411046 | Ims Urgent Care Dba Intergrated Medical Services, Inc. | Clinic/Center | 3540 E Baseline Rd, 131, Phoenix, AZ 85042-9627 | 2013-04-16 |
| 1376897314 | Zuleikha Vellani | Family Medicine | 3540 E Baseline Rd, Phoenix, AZ 85042-9627 | 2012-10-30 |
| 1881849891 | Hanger Prosthetics & Orthotics West, Inc. | Durable Medical Equipment & Medical Supplies | 3540 E Baseline Rd, Suite 100, Phoenix, AZ 85042-9627 | 2008-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306443197 | Da Homes LLC | Case Management | 8026 S. 24th Way, Phoenix, AZ 85042 | 2020-10-05 |
| 1144790460 | Ebony House Inc | Substance Abuse Rehabilitation Facility | 6222 S. 13th Street, Phoenix, AZ 85042 | 2018-11-29 |
| 1427538362 | Abigail Mcgrath | Dietitian, Registered | 303 E Baseline Rd Ste 200, Phoenix, AZ 85042 | 2018-08-20 |
| 1174028310 | Olufemi A Omodara | Pharmacist | 7227 S. Central Ave, #1080, Phoenix, AZ 85042 | 2018-03-29 |
| 1720537699 | Mary Youngblood | Registered Nurse | 7210 S 27th Way, Phoenix, AZ 85042 | 2016-10-03 |
| 1922490382 | Brian Zembower | Optometrist | 610 E Baseline Rd Ste C3, Phoenix, AZ 85042 | 2015-02-23 |
| 1417299819 | Robert Murphy Portley | Psychiatry & Neurology | 2320 E Baseline Rd Ste 148-225, Phoenix, AZ 85042 | 2013-03-23 |
| 1972807998 | Obinna Chukwuka Akubukwe | Pharmacist | 6006 S. Central Avenue, Phoenix, AZ 85042 | 2011-01-05 |
| 1104120328 | Gisheys Patient Care LLC | Custodial Care Facility | 7232 South 12th Place, Phoeniz, AZ 85042 | 2011-01-03 |
| 1245463488 | Lois Ann Hammitt | Registered Nurse | 6218 S. 7th Street, Phoenix, AZ 85042 | 2009-09-03 |
| Find all providers in zip 85042 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790384030 | Great Xpectations LLC | Community/Behavioral Health | 4014 W Christy Dr, Phoenix, AZ 85029-3958 | 2020-10-19 |
| 1386242295 | Mercy Cares LLC | Community/Behavioral Health | 2644 E Paradise Ln Apt D, Phoenix, AZ 85032-2945 | 2020-10-13 |
| 1124626080 | Beia's Families | Community/Behavioral Health | 3230 E Broadway Rd Ste C-235, Phoenix, AZ 85040-2873 | 2020-10-13 |
| 1518564442 | Infinity Groups Homes LLC | Community/Behavioral Health | 3523 E Everett Dr, Phoenix, AZ 85032-5136 | 2020-10-05 |
| 1013524230 | Civara Behavioral Health LLC | Community/Behavioral Health | 4010 W Cactus Rd, Phoenix, AZ 85029-2905 | 2020-10-01 |
| 1043827561 | Crossroads, Inc | Community/Behavioral Health | 2002 E Osborn Rd, Phoenix, AZ 85016-7236 | 2020-09-29 |
| 1043827025 | Guiding Steps Health Services, LLC | Community/Behavioral Health | 4926 E Mcdowell Rd, Phoenix, AZ 85008-4294 | 2020-09-24 |
| 1154931566 | Apex Transitional Housing Inc | Community/Behavioral Health | 13827 N 11th St, Phoenix, AZ 85022-4316 | 2020-08-01 |
| 1356959126 | Rock House Az, LLC | Community/Behavioral Health | 8650 N 35th Ave Ste 110, Phoenix, AZ 85051-3835 | 2020-07-17 |
| 1215554902 | Lydia Barton | Community/Behavioral Health | 1420 W Missouri Ave, Phoenix, AZ 85013-1919 | 2020-06-29 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.