NPIMap

Organization Active NPI

Lifewell Behavioral Wellness

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1154401156
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
BH2406 Issued in AZ
Legal business name
LIFEWELL BEHAVIORAL WELLNESS
Practice address
3222 N 37TH St
Phoenix, AZ 85018-6304
Phone
(602) 808-2800
Fax
(602) 808-2799
NPI assigned
Oct 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Thomas K McKelvey
Title
Chief Executive Officer
Phone
(602) 599-5410

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X BH2406 AZ Primary

Addresses

Primary practice location

3222 N 37TH St
Phoenix, AZ 85018-6304

Mailing address

202 E. Earll Drive
Suite 200
Phoenix, AZ 85012-2647
Phone (602) 808-2800

Other identifiers 1

IdentifierTypeStateIssuer
056970MedicaidAZ

National Provider Directory

National Provider Directory
Tax ID family
Lifewell19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481673600000",
    "number": "1154401156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E. EARLL DRIVE",
            "address_2": "SUITE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122647",
            "telephone_number": "602-808-2800",
            "fax_number": "602-808-2799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3222 N 37TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850186304",
            "telephone_number": "602-808-2800",
            "fax_number": "602-808-2799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWELL BEHAVIORAL WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2016-12-14",
        "status": "A",
        "authorized_official_last_name": "MCKELVEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "602-599-5410"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH2406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056970",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.