LIFEWELL BEHAVIORAL WELLNESS (NPI# 1720330194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720330194 |
| Entity Type | Organization |
| Organization Name | LIFEWELL BEHAVIORAL WELLNESS |
| Practice Address |
6915 E. Main Street Mesa AZ 85207-8201 |
| 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 | 2012-10-10 |
| Last Update Date | 2016-10-27 |
| Authorized Official Name | THOMAS K MCKELVEY (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6025995410 |
| Authorized Official Credential | CEO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | OTC6851 | AZ | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | MEDICARE PTAN | Z102186 | 01 |
| AZ | 762746 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1790160141 | Lifewell Behavioral Wellness | Community/Behavioral Health | 4451 E Oak St, Phoenix, AZ 85008-2410 | 2015-07-28 |
| Street Address |
6915 E. MAIN STREET |
| City | MESA |
| State | AZ |
| Zip Code | 85207-8201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790241743 | Sharin Lane | Physical Therapist | Spooner North Mesa, PC, 6824 E Brown Rd # 102, Mesa, AZ 85207 | 2019-02-14 |
| 1154898435 | Phoenix Physician Group, LLC | Emergency Medicine | 3430 N. Mountain Ridge, Unit 14, Mesa, AZ 85207 | 2018-10-25 |
| 1467970939 | Kerry Mae Kenley | Specialist/Technologist | 7556 E. Laurel St, Mesa, AZ 85207 | 2017-09-05 |
| 1053709287 | Barbara Bowen | Speech-Language Pathologist | 8433 E. Leland St., Mesa, AZ 85207 | 2014-12-22 |
| 1043561046 | Joseph Allen Kempton | Physical Therapist | 844 N. Ellsworth Rd, Mesa, AZ 85207 | 2012-10-01 |
| 1629327556 | Odyssey Services Corp. | Community/Behavioral Health | 8947 East Quill Street, Mesa, AZ 85207 | 2012-09-06 |
| 1962729160 | Chao Li | Dermatology | 6832 E Brown Rd, Mesa, AZ 85207 | 2010-04-27 |
| 1366670929 | Trevor Lee Caffall | Dentist | 6812 E. Brown Rd., Ste 102, Mesa, AZ 85207 | 2009-06-22 |
| 1396928073 | Dht Hand Therapy Limited Partnership | Occupational Therapist | 7165 E University Dr Ste 143, Mesa, AZ 85207 | 2007-12-17 |
| 1184794075 | Karen L Thomas Pllc | Nurse Practitioner | 3902 N. Stone Gully Cricle, Mesa, AZ 85207 | 2006-11-08 |
| Find all providers in zip 85207 | ||||
| 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.