Mohave Health and Wellness Center LLC

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

MOHAVE HEALTH AND WELLNESS CENTER LLC

Practice address

1940 Mesquite Ave Ste P-1
Lake Havasu City, AZ 86403-6123

Phone

(602) 706-4405

NPI assigned

May 23, 2023

Organization subpart

No

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

Authorized official

Name

Shanese Diamond

Title

Owner

Phone

(480) 521-9859

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1346932811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 MESQUITE AVE STE P-1",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 MESQUITE AVE STE P-1",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036123",
            "telephone_number": "602-706-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAVE HEALTH AND WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-23",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-24",
        "status": "A",
        "authorized_official_last_name": "DIAMOND",
        "authorized_official_first_name": "SHANESE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-521-9859"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel Mills
• Todd Pete Minkey Jr., LACT
• Taylor Ann Miracle, DC
• Mobility Prosthetic and Orthotic Services LLC
• Mohave Centre for Plastic Surgery
• Mohave Healthcare, Inc.
• Mohave Infectious Disease,PLLC
• Mohave Medical Imaging Center
• Mohave Mental Health Clinic Inc
• Mohave Mental Health Clinic, Inc.

• Community Health Clinic/Center in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Community Health Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.