Light Center Behavioral Health LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

LIGHT CENTER BEHAVIORAL HEALTH LLC

Practice address

6619 N 19TH Ave # C1
Phoenix, AZ 85015-1631

Phone

(520) 445-5832

NPI assigned

Dec 14, 2022

Last updated

Dec 14, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Anne Marie Ntiranyibagira

Title

Partner

Phone

(520) 445-5832

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670976000000",
    "number": "1700598489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6619 N 19TH AVE # C1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850151631",
            "telephone_number": "520-445-5832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6619 N 19TH AVE # C1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850151631",
            "telephone_number": "520-445-5832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHT CENTER BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-14",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A",
        "authorized_official_last_name": "NTIRANYIBAGIRA",
        "authorized_official_first_name": "ANNE MARIE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "520-445-5832"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BH8241",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "LIGHTCENTERBH@GMAIL.COM",
            "affiliation": "N",
            "endpointDescription": "EMAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6619 N 19th Ave # C1",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850151631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lifewell Behavioral Wellness
• Lifewell Behavioral Wellness
• Lifewell Behavioral Wellness (Lifewell Behavioral Wellness - Royal Palms)
• Lifting Spirits Inc.
• Melissa Lynn Liggins, NNP
• Light House Family Services
• Light-Point Wellness, LLC
• Amy Jo Light, MD.
• Esenia Linda Lightbourne, LPN
• Andrew Edward Liguori, DO

• Adult Mental Health Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Adult Mental Health Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; 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.