Organization Active NPI

Bonding Wellness LLC

  • Adult Mental Health Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1841973583
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
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

Updated by the provider on Aug 9, 2023

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)CodeLicenseStatePrimary
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 Directory

Locations

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.

Verify at the official NPI Registry.