LIFEWELL BEHAVIORAL WELLNESS (NPI# 1255547444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255547444 |
| Entity Type | Organization |
| Organization Name | LIFEWELL BEHAVIORAL WELLNESS |
| Practice Address |
119 W. Highland Avenue Phoenix AZ 85013-4707 |
| 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 | 2007-05-15 |
| Last Update Date | 2016-12-14 |
| Authorized Official Name | MR. THOMAS K MCKELVEY (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6025995410 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251V00000X | Voluntary or Charitable | BH2881 | AZ | Agencies |
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | BH4220 | AZ | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 960302 | 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 |
| 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 |
| 1790160141 | Lifewell Behavioral Wellness | Community/Behavioral Health | 4451 E Oak St, Phoenix, AZ 85008-2410 | 2015-07-28 |
| Street Address |
119 W. HIGHLAND AVENUE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85013-4707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043833700 | Marco Antonio Valdez Espinoza | Student in an Organized Health Care Education/Training Program | 500 W. Thomas Road, Suite 900 A, Phoenix, AZ 85013 | 2020-05-28 |
| 1518588292 | Santiago Garcia Ortiz | Student in an Organized Health Care Education/Training Program | 350w Thomas Rd St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013 | 2020-05-04 |
| 1356811970 | Lynne Shaunte Coleman | Nurse Practitioner | 3633 N 3rd Ave 2019, Phoenix, AZ 85013 | 2018-11-26 |
| 1467949156 | Solterra 3rd Indian School Operations, LLC | Assisted Living Facility | 4000 N 3rd Avenue, Phoenix, AZ 85013 | 2018-04-18 |
| 1083018345 | Romelda Antonio | Nurse Practitioner | 222 W Thomas Rd Ste 212, Phoenix, AZ 85013 | 2014-10-15 |
| 1760890131 | Emmitt Michael Thompson | General Practice | 822 West Earll Drive, Phoenix, AZ 85013 | 2014-07-29 |
| 1902218480 | Sreeja Biswas Roy | Internal Medicine | 350 W Thomas Road, Phoenix, AZ 85013 | 2014-06-02 |
| 1417381120 | Osama Qasim Agha | Internal Medicine | 350 W. Thomas Road, Suite 900a, Phoenix, AZ 85013 | 2013-08-29 |
| 1245679604 | Oculist Exceptional Eyewear Pllc | Optometrist | 5043-b N 7th Ave, Phoenix, AZ 85013 | 2013-06-19 |
| 1760829352 | Gina Wilding | Nurse Practitioner | 500 W Thomas Rd Ste 720, Phoenix, AZ 85013 | 2013-05-23 |
| Find all providers in zip 85013 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235736018 | Happy Valley Community Services LLC | Community Based Residential Treatment Facility, Mental Illness | 1106 E Cochise Dr, Phoenix, AZ 85020-1550 | 2020-10-05 |
| 1639782956 | Ascend Behavioral Health and Wellness,llc | Community Based Residential Treatment Facility, Mental Illness | 3308 W Desert Vista Trl, Phoenix, AZ 85083-5874 | 2020-08-26 |
| 1588281604 | Alliance Behavioral Care LLC | Community Based Residential Treatment Facility, Mental Illness | 1402 E Hoover Ave, Phoenix, AZ 85006-1737 | 2020-07-06 |
| 1174143846 | Alpine Villa LLC | Community Based Residential Treatment Facility, Mental Illness | 14414 N 29th St, Phoenix, AZ 85032-5004 | 2020-04-22 |
| 1346860657 | Semper Fidelis Behavioral Health & Counseling, LLC | Community Based Residential Treatment Facility, Mental Illness | 3606 E Baseline Rd Unit 288, Phoenix, AZ 85042-9617 | 2020-04-16 |
| 1548889793 | Shea Home LLC | Community Based Residential Treatment Facility, Mental Illness | 10435 N 40th St, Phoenix, AZ 85028-4043 | 2020-04-08 |
| 1699394858 | Acome Home LLC | Community Based Residential Treatment Facility, Mental Illness | 4509 E Acoma Dr, Phoenix, AZ 85032-4855 | 2020-04-08 |
| 1033748009 | Optimum Care of Arizona LLC | Community Based Residential Treatment Facility, Mental Illness | 717 E Harwell Rd, Phoenix, AZ 85042-6655 | 2020-04-02 |
| 1043846561 | Happy Haven Az LLC | Community Based Residential Treatment Facility, Mental Illness | 1110 W Hadley St, Phoenix, AZ 85007-3610 | 2020-03-16 |
| 1942835806 | Mercy Favor and Grace Social Services | Community Based Residential Treatment Facility, Mental Illness | 9431 W Sheridan St, Phoenix, AZ 85037-4435 | 2020-03-10 |
| 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.