LIFEWELL BEHAVIORAL WELLNESS (NPI# 1255716601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255716601 |
| Entity Type | Organization |
| Organization Name | LIFEWELL BEHAVIORAL WELLNESS |
| Practice Address |
2715 N 3rd St Phoenix AZ 85004-1106 |
| Mailing Address |
202 E Earll Dr Suite 200 Phoenix AZ 85012-2634 |
| Practice Telephone | 6028082800 |
| Mailing Telephone | 6028082800 |
| 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 | OTC7723 | AZ | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 037436 | 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 |
| 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 |
2715 N 3RD ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85004-1106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982685954 | Maryanne C Clark | Nurse Practitioner | 2715 N 3rd St, Phoenix, AZ 85004-1106 | 2005-11-08 |
| 1134614324 | Jillian Young | Nurse Practitioner | 2715 N 3rd St, Phoenix, AZ 85004-1106 | 2018-06-29 |
| 1659866416 | Lillian Wei Chang | Nurse Practitioner | 2715 N 3rd St, Phoenix, AZ 85004-1106 | 2018-06-25 |
| 1922505908 | Munachiso Iheonunekwu | Nurse Practitioner | 2715 N 3rd St, Phoenix, AZ 85004 | 2018-04-06 |
| 1588111264 | Brian Thomas | Nurse Practitioner | 2715 N 3rd St, Phoenix, AZ 85004-1106 | 2016-09-09 |
| 1760401483 | Alvin Elmo Mercer | Nurse Practitioner | 2715 N 3rd St, Phoenix, AZ 85004-1106 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396360749 | Ulivvo Inc. | Nurse Practitioner | 141 E Palm Lane, Suite 206, Phoenix, AZ 85004 | 2020-06-11 |
| 1508325929 | Ican America | Clinic/Center | Cityscape Tower 1 E Washington St., Suite 440, Phoenix, AZ 85004 | 2019-03-15 |
| 1770064107 | Edward Jude Stein | Pharmacist | Two Renaissance Square, 40 N Central Ave, Suite 780, Ihs Clinical Support Center, Phoenix, AZ 85004 | 2018-08-23 |
| 1740775303 | Alexander L. Shaw | Dentist | 201 N Central Ave. #1490, Phoenix, AZ 85004 | 2018-06-26 |
| 1497267868 | Michael Dimoff | Registered Nurse | 1850 N. Central Ave, Ste 1600, Phoenix, AZ 85004 | 2017-10-25 |
| 1093231433 | Ezequiel Bautista | Music Therapist | 2702 N 3rd Street, Suite 1000, Phoenix, AZ 85004 | 2017-08-17 |
| 1841742442 | Stacy Maahs | Nurse Practitioner | 500 N 3rd St Ste 155, Phoenix, AZ 85004 | 2016-10-29 |
| 1538537246 | Jessica Lindsay Karlson | Pharmacist | 2302 N Central Ave Ste 7, Phoenix, AZ 85004 | 2015-09-11 |
| 1689059883 | Yvette's Hope Foundation | Home Health | 40 N. Central Ave. Ste. 1400, Phoenix, AZ 85004 | 2015-07-29 |
| 1881082790 | Patricia Russell | Specialist/Technologist | 60 E. Vernon Ave, Arcadia Therapy Services, Phoenix, AZ 85004 | 2014-12-30 |
| Find all providers in zip 85004 | ||||
| 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.