Community Hope Wellness Center LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

COMMUNITY HOPE WELLNESS CENTER LLC

Practice address

14001 N 7TH St Ste A101
Phoenix, AZ 85022-4382

Phone

(520) 431-8744

NPI assigned

Jul 18, 2022

Organization subpart

No

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

Authorized official

Name

Daud Koleosho, NP

Title

Admin

Phone

(520) 431-8744

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658102400000",
    "number": "1922733641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 W KNIGHT LN",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852841369",
            "telephone_number": "623-225-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14001 N 7TH ST STE A101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850224382",
            "telephone_number": "520-431-8744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HOPE WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-18",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A",
        "authorized_official_last_name": "KOLEOSHO",
        "authorized_official_first_name": "DAUD",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "520-431-8744",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZDHS-MEDICAL FACILITIES LICENSING",
            "identifier": "OTC11822",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "secureid",
            "affiliation": "N",
            "address_1": "14001 N 7th St Ste A101",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850224382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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