PROGRESSIVE LIVING WELLNESS CENTER LLC NPI 1235863531

NPI Information

NPI: 1235863531
Provider Name: PROGRESSIVE LIVING WELLNESS CENTER, LLC
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
2177 E WARNER RD STE 101
TEMPE, AZ
ZIP 85284
Phone: (480) 773-8480
Get Directions

PROGRESSIVE LIVING WELLNESS CENTER, LLC is an adult mental health clinic center in Tempe, AZ. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. PROGRESSIVE LIVING WELLNESS CENTER, LLC NPI is 1235863531. The provider is registered as an organization entity type.

The provider's business location address is:

2177 E WARNER RD STE 101
TEMPE, AZ
ZIP 85284-511
Phone: (480) 773-8480
Fax: (480) 546-3626

The provider's authorized official is Lyddia Getaweru .
The authorized official title is Executive Director and has the following contact phone number (480) 773-8480.

The enumeration date for this NPI number is 7/12/2022 and was last updated on 7/12/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	251B00000X	Case Management		No
2	251S00000X	Community/Behavioral Health		No
3	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
4	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	No
5	261QR0800X	Clinic/Center	Recovery Care	No
6	261QM0850X	Clinic/Center	Adult Mental Health	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	BH7784	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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