Embark Wellness Center LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EMBARK WELLNESS CENTER LLC

Practice address

1717 W Northern Ave Ste 209
Phoenix, AZ 85021-5471

Phone

(239) 745-2517

NPI assigned

May 24, 2022

Organization subpart

No

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

Authorized official

Name

Kedha AlceNPI 1467110676

Title

Owner

Phone

(239) 745-2517

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kedha Alce

  • Addiction (Substance Use Disorder) Counselor
  • Phoenix, AZ
  • NPI 1467110676
  NPD Authorized official

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653350400000",
    "number": "1912645433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 W NORTHERN AVE STE 209",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850215471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W NORTHERN AVE STE 209",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850215471",
            "telephone_number": "239-745-2517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBARK WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-24",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A",
        "authorized_official_last_name": "ALCE",
        "authorized_official_first_name": "KEDHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-745-2517"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Ely, PMHNP
• Rebecca Lynn Ely
• Stephen Lawrence Ely, D.C.
• Roodjery Elysee
• Elytra Corp
• Embers Outpatient LLC
• Embody Physical Therapy LLC
• Embrace Behavioral Health, PLLC
• Embrace Home Home Health Agency (Embrace Hope Home Health Care)
• Embrace Hope Behavioral Health

• Mental Health Clinic/Center (Including Community Mental Health Center) in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.