NPIMap

Organization Active NPI

Lifewell Behavioral Wellness

  • Community/Behavioral Health Agency
  • Phoenix, AZ
National Provider Identifier
1982191284
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LIFEWELL BEHAVIORAL WELLNESS
Practice address
10844 N 23Rd Ave Ste 200
Phoenix, AZ 85029-4947
Phone
(602) 353-2340
Fax
(602) 353-2400
NPI assigned
Apr 23, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2021

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

Authorized official

Name
Doris Vaught
Title
President and Ceo
Phone
(602) 599-5420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

10844 N 23Rd Ave Ste 200
Phoenix, AZ 85029-4947

Mailing address

202 E Earll Dr Ste 200
Phoenix, AZ 85012-2647
Phone (602) 599-5434

Other identifiers 1

IdentifierTypeStateIssuer
444173MedicaidAZ

Other names 1

  • Lifewell Behavioral Wellness - Royal Palms Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lifewell19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

10844 N 23rd Ave
Ste 200
Phoenix, AZ 85029
Phone (602) 353-2340

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622160000000",
    "number": "1982191284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E EARLL DR STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122647",
            "telephone_number": "602-599-5434",
            "fax_number": "602-599-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10844 N 23RD AVE STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294947",
            "telephone_number": "602-353-2340",
            "fax_number": "602-353-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWELL BEHAVIORAL WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-23",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A",
        "authorized_official_last_name": "VAUGHT",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "602-599-5420"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "444173",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifewell Behavioral Wellness - Royal Palms",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lifewell Behavioral Wellness - Royal Palms",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 28, 2021; 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.