Active NPI
Bonding Wellness LLC
- Adult Mental Health Clinic/Center
- Phoenix, AZ
National Provider Identifier
1841973583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Mental Health Clinic/Center
- Legal business name
- BONDING WELLNESS LLC
- Practice address
- 3420 E Shea Blvd
Phoenix, AZ 85028-3345 - Phone
- (832) 206-3708
- NPI assigned
- Aug 9, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mutoni Masengesho
- Title
- Administrator
- Phone
- (832) 206-3708
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Meals Provider | 174200000X | |||
| Case Management Agency | 251B00000X | |||
| Community/Behavioral Health Agency | 251S00000X | |||
| Adult Mental Health Clinic/Center | 261QM0850X | Primary | ||
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X |
Addresses
Primary practice location
3420 E Shea Blvd
Phoenix, AZ 85028-3345
Mailing address
3420 E Shea Blvd
Phoenix, AZ 85028-3345
National Provider Directory
National Provider DirectoryLocations
3420 E Shea Blvd
Phoenix, AZ 85028
Phone (602) 730-4105
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691539200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1691539200000",
"number": "1841973583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3420 E SHEA BLVD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850283345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3420 E SHEA BLVD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850283345",
"telephone_number": "832-206-3708"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BONDING WELLNESS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-08-09",
"last_updated": "2023-08-09",
"certification_date": "2023-08-09",
"status": "A",
"authorized_official_last_name": "MASENGESHO",
"authorized_official_first_name": "MUTONI",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "832-206-3708"
},
"taxonomies": [
{
"code": "174200000X",
"taxonomy_group": "",
"desc": "Meals",
"state": null,
"license": null,
"primary": false
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QR0405X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"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 Aug 9, 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.