LIFEWELL BEHAVIORAL WELLNESS (NPI# 1689756215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689756215 |
| Entity Type | Organization |
| Organization Name | LIFEWELL BEHAVIORAL WELLNESS |
| Practice Address |
650 W Southern Ave Mesa AZ 85210-5032 |
| Mailing Address |
2715 N 3rd St Phoenix AZ 85004-1100 |
| Practice Telephone | 6025537300 |
| Practice Fax Number | 6025537303 |
| Mailing Telephone | 6025537300 |
| Mailing Fax Number | 6025537303 |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2011-05-25 |
| Authorized Official Name | MR. THOMAS K MCKELVEY (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6025537300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | BH - 2935 | AZ | Agencies |
| 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 |
650 W SOUTHERN AVE |
| City | MESA |
| State | AZ |
| Zip Code | 85210-5032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205818614 | Tutankhamen A Pappoe | Physical Medicine & Rehabilitation | 650 W Southern Ave, 2, Mesa, AZ 85210-5012 | 2005-11-20 |
| 1053717298 | Cher Ann Roanhorse | Case Manager/Care Coordinator | 650 W Southern Ave, Mesa, AZ 85210-5032 | 2014-11-17 |
| 1255737490 | Kathryn Marie Woolley | Driver | 650 W Southern Ave, Mesa, AZ 85210-5032 | 2014-11-17 |
| 1013313261 | George Montiel | Driver | 650 W Southern Ave, Mesa, AZ 85210-5032 | 2014-11-17 |
| 1013313485 | Susan Jean Henry | Case Manager/Care Coordinator | 650 W Southern Ave, Mesa, AZ 85210-5032 | 2014-11-13 |
| 1366848012 | Daniel Stephen Frimer | Driver | 650 W Southern Ave, Mesa, AZ 85210-5032 | 2014-11-07 |
| 1841498474 | New Arizona Family Inc | Voluntary or Charitable | 650 W Southern Ave, Mesa, AZ 85210-5032 | 2007-07-05 |
| 1316005283 | Robert Dean Hunn | Pediatrics | 650 W Southern Ave, Ste 1, Mesa, AZ 85210 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497382501 | Mesa Center for Family Medicine | Internal Medicine | 2034 S Alma School Road, Suite #101, Mesa, AZ 85210 | 2020-03-26 |
| 1780177121 | Jessica Cannata | Speech-Language Pathologist | 2150 S Country Club Rd, Suite 20, Mesa, AZ 85210 | 2018-06-11 |
| 1831680305 | Alexandra Katherine Ebong | Nurse Practitioner | 1950 S. Country Club Drive, Ste 102, Mesa, AZ 85210 | 2018-05-21 |
| 1548762719 | Russell D. Meldrum, M.d. Pllc | Orthopaedic Surgery | 855 W. Southern Ave., #1114, Mesa, AZ 85210 | 2018-03-05 |
| 1023510435 | Denise M Bruno-krupp | Counselor | 1830 S. Alma School Rd. Suite 101, Mesa, AZ 85210 | 2018-03-01 |
| 1609374529 | Gene R Lullo | Social Worker | 1830 S Alma School Rd Suite 101, Mesa, AZ 85210 | 2018-01-25 |
| 1295264000 | Ashley P Smith | Naturopath | 601 S Alma School Rd, Apt 101, Mesa, AZ 85210 | 2017-06-06 |
| 1386184059 | Brittany Johnson | Counselor | 1745 S Alma School Rd Ste 230, Mesa, AZ 85210 | 2017-03-01 |
| 1487190880 | Mesa Valley Modern Dentistry, LLP | Dentist | 1712 S, Country Club Drive, Ste 104, Mesa, AZ 85210 | 2017-01-10 |
| 1821544529 | Sandra Coren | Licensed Practical Nurse | 32 S Mcdonald, Tlc, Mesa, AZ 85210 | 2016-09-01 |
| Find all providers in zip 85210 | ||||
| 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 |
|---|---|---|---|---|
| 1710586144 | Brighter Tomorrow's Family Services, LLC | Community/Behavioral Health | 644 N Country Club Dr Ste D, Mesa, AZ 85201-4983 | 2020-10-16 |
| 1073120390 | Harmony Behavioral Home LLC | Community/Behavioral Health | 5437 E Harmony Ave, Mesa, AZ 85206-6750 | 2020-09-30 |
| 1992311716 | Life Force Community Services | Community/Behavioral Health | 1237 S Val Vista Dr Ste 113, Mesa, AZ 85204-6401 | 2020-09-17 |
| 1326650417 | Fresh Start Rescource Center LLC | Community/Behavioral Health | 840 E Mckellips Rd Ste 109, Mesa, AZ 85203-9654 | 2020-08-19 |
| 1679182745 | A Nod To Veterans LLC | Community/Behavioral Health | 2436 S Lennox, Mesa, AZ 85209-6663 | 2020-07-24 |
| 1205452117 | Md Life Strategies, Inc | Community/Behavioral Health | 7435 E Main St, Mesa, AZ 85207-8337 | 2020-06-17 |
| 1346864147 | Rising Youth LLC | Community/Behavioral Health | 5948 E Fountain Cir, Mesa, AZ 85205-5513 | 2020-06-08 |
| 1225659121 | Amazing Hope LLC | Community/Behavioral Health | 7103 E Onza Ave, Mesa, AZ 85212-9811 | 2020-05-01 |
| 1912535337 | Harmony Family Services II | Community/Behavioral Health | 2812 N Norwalk Ste 103, Mesa, AZ 85215-1148 | 2020-03-31 |
| 1528692118 | Sage Counseling, Inc. | Community/Behavioral Health | 460 N Mesa Dr Ste 116b, Mesa, AZ 85201-5974 | 2020-02-24 |
| Find all providers in MESA | ||||
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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.