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LIFEWELL BEHAVIORAL WELLNESS NPI 1386939247


NPI Information

NPI: 1386939247
Provider Name: LIFEWELL BEHAVIORAL WELLNESS

Doing Business As: LIFEWELL - UNIVERSITY

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 03D2114881

Address:
262 E. UNIVERSITY DRIVE
MESA, AZ
ZIP 85201
Phone: (602) 808-2800
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LIFEWELL BEHAVIORAL WELLNESS is a community behavioral health in Mesa, AZ. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, 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. LIFEWELL BEHAVIORAL WELLNESS NPI is 1386939247. The provider is registered as an organization entity type.
The provider Is Doing Business As Lifewell - University.

The provider's business location address is:

262 E. UNIVERSITY DRIVE
MESA, AZ
ZIP 85201-932
Phone: (602) 808-2800
Fax: (602) 808-2750

The provider's authorized official is Doris Vaught .
The authorized official title is Chief Executive Officer and has the following contact phone number (602) 599-5420.

The CLIA number assigned to this NPI record is 03D2114881 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/17/2011 and was last updated on 11/23/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral HealthOTC5920ARIZONAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1617167MEDICAIDARIZONA

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.