NPIMap

Organization Active NPI

Lifewell Behavioral Wellness

Doing business as Lifewell - University

  • Community/Behavioral Health Agency
  • Mesa, AZ
National Provider Identifier
1386939247
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
OTC5920 Issued in AZ
Legal business name
LIFEWELL BEHAVIORAL WELLNESS
Doing business as
Lifewell - University
Practice address
262 E. University Drive
Mesa, AZ 85201-5932
Phone
(602) 808-2800
Fax
(602) 808-2750
NPI assigned
Jun 17, 2011
Last updated
Nov 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Authorized official

Name
Doris Vaught
Title
Chief Executive Officer
Phone
(602) 599-5420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X OTC5920 AZ Primary

Addresses

Primary practice location

262 E. University Drive
Mesa, AZ 85201-5932

Mailing address

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

Other names 1

  • Lifewell - University Doing business as

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

NPI Registry JSON

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1386939247",
    "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": "602-808-2755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 E. UNIVERSITY DRIVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852015932",
            "telephone_number": "602-808-2800",
            "fax_number": "602-808-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWELL BEHAVIORAL WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-17",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "VAUGHT",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "602-599-5420"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "OTC5920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifewell - University",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; 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.