NPIMap

Organization Active NPI

Lifewell Behavioral Wellness

  • Community/Behavioral Health Agency
  • Phoenix, AZ
National Provider Identifier
1790160141
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
0TC7467 Issued in AZ
Legal business name
LIFEWELL BEHAVIORAL WELLNESS
Practice address
4451 E Oak St
Phoenix, AZ 85008-2410
Phone
(602) 808-2800
Fax
(602) 808-2799
NPI assigned
Jul 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Authorized official

Name
Ms. Doris Vaught
Title
Executive Vice President/Cfo
Phone
(602) 599-5420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 0TC7467 AZ Primary

Addresses

Primary practice location

4451 E Oak St
Phoenix, AZ 85008-2410

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
037418MedicaidAZ

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

Locations

202 E Earll Dr
Ste 200
Phoenix, AZ 85012
Phone (602) 599-5404

3311 N 44th St
Ste 100
Phoenix, AZ 85018
Phone (602) 957-2220

NPI Registry JSON

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477612800000",
    "number": "1790160141",
    "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": "4451 E OAK ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850082410",
            "telephone_number": "602-808-2800",
            "fax_number": "602-808-2799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWELL BEHAVIORAL WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-28",
        "last_updated": "2016-10-28",
        "status": "A",
        "authorized_official_last_name": "VAUGHT",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT/CFO",
        "authorized_official_telephone_number": "602-599-5420",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "0TC7467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037418",
            "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 Oct 28, 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.