LIFEWELL BEHAVIORAL WELLNESS (NPI# 1306928932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306928932 |
| Entity Type | Organization |
| Organization Name | LIFEWELL BEHAVIORAL WELLNESS |
| Practice Address |
3301 E Pinchot Ave Phoenix AZ 85018-6807 |
| 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 | 2006-10-20 |
| Last Update Date | 2016-11-03 |
| Authorized Official Name | THOMAS K MCKELVEY (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6025995410 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | BH165 | AZ | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 056962 | 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 |
| 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 |
3301 E PINCHOT AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85018-6807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811395189 | Andrew Smith | Case Manager/Care Coordinator | 3301 E Pinchot Ave, Phoenix, AZ 85018-6807 | 2014-12-18 |
| 1447657127 | Ruth Junek Wheeler | Case Manager/Care Coordinator | 3301 E Pinchot Ave, Phoenix, AZ 85018-6807 | 2014-11-25 |
| 1225434228 | Katherine Cheryl Nisbet | Counselor | 3301 E Pinchot Ave, Phoenix, AZ 85018-6807 | 2014-11-18 |
| 1376949511 | James Adolph Sabata | Case Manager/Care Coordinator | 3301 E Pinchot Ave, Phoenix, AZ 85018-6807 | 2014-11-17 |
| 1730585167 | Susan Dale Heehler | Social Worker | 3301 E Pinchot Ave, Phoenix, AZ 85018-6807 | 2014-11-12 |
| 1619373057 | Hazle Laverne Crockett | Case Manager/Care Coordinator | 3301 E Pinchot Ave, Phoenix, AZ 85018-6807 | 2014-11-12 |
| 1295131787 | Esperanza Rebecca Haynes | Case Manager/Care Coordinator | 3301 E Pinchot Ave, Phoenix, AZ 85018-6807 | 2014-11-10 |
| 1588060123 | Vanita J Harris | Community Health Worker | 3301 E Pinchot Ave, Phoenix, AZ 85018-6807 | 2014-11-10 |
| 1679979488 | Terry Jean Bechtold | Case Manager/Care Coordinator | 3301 E Pinchot Ave, Phoenix, AZ 85018-6807 | 2014-11-06 |
| 1346642204 | Connie Nies | Registered Nurse | 3301 E Pinchot Ave, Phoenix, AZ 85018-6807 | 2014-09-23 |
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| 1124547682 | Consulting Options, LLC | Orthopaedic Surgery | 5110 North 44th Street, Suite L200, Phoenix, AZ 85018 | 2017-09-15 |
| 1902322472 | Saskia Soliz | Behavioral Analyst | 2940 N 40th Street, Unit 19, Phoenix, AZ 85018 | 2017-08-16 |
| 1700233418 | Harriet Frost | Marriage & Family Therapist | 4500 N. 32nd Street, Suite 100-d, Phoenix, AZ 85018 | 2016-05-23 |
| 1356733547 | Margaret Murphy Conley | Acupuncturist | 3040 N 44th St Ste 3, Phoenix, AZ 85018 | 2015-02-24 |
| 1457766792 | Anne Marie Hatch | Psychiatry & Neurology | 5090 N 40th St Ste 250a, Phoenix, AZ 85018 | 2014-06-25 |
| 1972848315 | Crystal M Ostermeyer | Physician Assistant | 4350 East Camelback Rd, Suite G-100, Phoenix, AZ 85018 | 2012-12-11 |
| 1699029652 | Monte Vista School | Local Education Agency (LEA) | 3501 E. Osborn Road, Phoenix, AZ 85018 | 2012-10-30 |
| 1962754028 | Jill R. Zweig D.o., PC | Psychiatry & Neurology | 5110 N 40th Street, Suite 104, Phoenix, AZ 85018 | 2012-10-12 |
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| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
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|---|---|---|---|---|
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| 1558988246 | Cmj Recovery Az LLC | Substance Abuse Rehabilitation Facility | 4122 N 17th St Bldg A, Phoenix, AZ 85016-5922 | 2020-06-29 |
| 1720549009 | Rtc Management Group, LLC | Substance Abuse Rehabilitation Facility | 1340 E Desert Cove Ave, Phoenix, AZ 85020-1110 | 2019-03-28 |
| 1497227771 | Vogue Recovery Center Outpatient | Substance Abuse Rehabilitation Facility | 4122 N 17th St Bldg C, Phoenix, AZ 85016-5922 | 2018-12-26 |
| 1780155077 | Pb Medical Group of Arizona, LLC | Substance Abuse Rehabilitation Facility | 3000 N 91st Ave, Phoenix, AZ 85037-4037 | 2018-12-11 |
| 1144790460 | Ebony House Inc | Substance Abuse Rehabilitation Facility | 6222 S. 13th Street, Phoenix, AZ 85042 | 2018-11-29 |
| 1891283149 | Bbc Whitton, LLC | Substance Abuse Rehabilitation Facility | 1106 E Whitton Ave, Phoenix, AZ 85014-5053 | 2018-04-23 |
| 1417456336 | Vogue Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 4122 N 17th St, Phoenix, AZ 85016-5922 | 2018-02-06 |
| 1992254338 | A Path of Resilience | Substance Abuse Rehabilitation Facility | 6102 S 37th Ln, Phoenix, AZ 85041-5021 | 2016-09-27 |
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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.