Lifewell Behavioral Wellness | |
40 E Mitchell Dr Ste 100&200 Phoenix AZ 85012-2330 | |
(602) 808-2800 | |
Not Available |
Full Name | Lifewell Behavioral Wellness |
---|---|
Speciality | Community/behavioral Health |
Location | 40 E Mitchell Dr Ste 100&200, Phoenix, Arizona |
Authorized Official Name and Position | Doris Vaught (PRESIDENT/CEO) |
Authorized Official Contact | 6025995420 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Lifewell Behavioral Wellness 202 E Earll Dr Suite 200 Phoenix AZ 85012-2634 Ph: (602) 808-2800 | Lifewell Behavioral Wellness 40 E Mitchell Dr Ste 100&200 Phoenix AZ 85012-2330 Ph: (602) 808-2800 |
NPI Number | 1255716601 |
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Provider Enumeration Date | 07/28/2015 |
Last Update Date | 07/17/2024 |
Certification Date | 07/17/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255716601 | NPI | - | NPPES |
494978 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | OTC7723 (Arizona) | Primary |
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