LIFEWELL BEHAVIORAL WELLNESS (NPI# 1790160141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790160141 |
| Entity Type | Organization |
| Organization Name | LIFEWELL BEHAVIORAL WELLNESS |
| Practice Address |
4451 E Oak St Phoenix AZ 85008-2410 |
| Mailing Address |
202 E Earll Drive Suite 200 Phoenix AZ 85012-2647 |
| Practice Telephone | 6028082800 |
| Practice Fax Number | 6028082799 |
| Mailing Telephone | 6028082800 |
| Mailing Fax Number | 6028082799 |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2016-10-28 |
| Authorized Official Name | MS. DORIS VAUGHT (EXECUTIVE 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 | 0TC7467 | AZ | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 037418 | 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 |
| 1609251057 | Lifewell Behavioral Wellness | Community/Behavioral Health | 3540 E Baseline Rd, Suite 150, Phoenix, AZ 85042-9630 | 2015-07-28 |
| Street Address |
4451 E OAK ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85008-2410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598737363 | Ivan J Engel | Psychiatry & Neurology | 4451 E Oak St, Phoenix, AZ 85008-2410 | 2006-02-06 |
| 1407201288 | Laurie Timarac | Social Worker | 4451 E Oak St, Phoenix, AZ 85008-2410 | 2016-04-28 |
| 1194012005 | Tamar Greenly | Nurse Practitioner | 4451 E Oak St, Phoenix, AZ 85008-2410 | 2011-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821607060 | Am Apnea and Tmj LLC | Durable Medical Equipment & Medical Supplies | 2303 N. 44thst., Suite 14-1008, Phoenix, AZ 85008 | 2020-07-23 |
| 1194341131 | Abdulbaril Olandapo Olagunju | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt Street, Valleywise Health, Phoenix, AZ 85008 | 2020-06-24 |
| 1376164632 | Abdul Rahman Raed Mustafa Halawa | Student in an Organized Health Care Education/Training Program | 2601 E Roosevelt St Valleywise Health, Phoenix, AZ 85008 | 2020-04-28 |
| 1245869460 | Zachary Masuda | Student in an Organized Health Care Education/Training Program | Valleywise Health Medical Center, 2601 E Roosevelt St, Phoenix, AZ 85008 | 2020-04-08 |
| 1942840145 | Cana Behavior LLC | Physical Therapist | 2412 N 36 Pl, Phoenix, AZ 85008 | 2020-01-15 |
| 1871158188 | Fred Gardezy | Student in an Organized Health Care Education/Training Program | Maricopa Integrated Health System 2601 E. Roosevelt St., Phoenix, AZ 85008 | 2019-05-02 |
| 1225692346 | Navkaran Singh Girgla | Student in an Organized Health Care Education/Training Program | 2601 East Roosevelt St., Phoenix, AZ 85008 | 2019-04-24 |
| 1316412323 | Southwest Human Developement | Early Intervention Provider Agency | 2850 N 24h Street, Phoenix, AZ 85008 | 2018-10-05 |
| 1558885970 | Mona Ridhwan Ziems | Midwife | 1919 N 31st St, Phoenix, AZ 85008 | 2017-07-27 |
| 1093244451 | Shana Cynamon | Audiologist | 1801 N 37th Pl, Phoenix, AZ 85008 | 2017-06-08 |
| Find all providers in zip 85008 | ||||
| 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.