Ani-G Wellness Residency LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ANI-G WELLNESS RESIDENCY LLC

Practice address

20278 N Wilford Ave
Maricopa, AZ 85138-6781

Phone

(480) 228-4001

NPI assigned

May 11, 2023

Last updated

May 18, 2023By 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

Kwame Konnor, PHARMD

Title

Administrator

Phone

(480) 287-2931

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684368000000",
    "number": "1801586805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20278 N WILFORD AVE",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851386781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20278 N WILFORD AVE",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851386781",
            "telephone_number": "480-228-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANI-G WELLNESS RESIDENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-11",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A",
        "authorized_official_last_name": "KONNOR",
        "authorized_official_first_name": "KWAME",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "480-287-2931",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; 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.