{"npi":"1255716601","type":"NPI-2","status":"active","name":{"display":"Lifewell Behavioral Wellness","other":[],"organization_name":"LIFEWELL BEHAVIORAL WELLNESS","authorised_official":"Doris Vaught"},"specialty":{"primary_taxonomy":"251S00000X","primary_taxonomy_description":"Community/Behavioral Health Agency","slug":"community-behavioral-health-agency","schema_org_specialty":null,"all":[{"code":"251S00000X","description":"Community/Behavioral Health Agency","primary":true,"state":"AZ","license":"OTC7723"}]},"addresses":[{"purpose":"LOCATION","street_1":"40 E MITCHELL DR STE 100&200","city":"PHOENIX","state":"AZ","postal_code":"850122330","country_code":"US","phone":"6028082800"},{"purpose":"MAILING","street_1":"202 E EARLL DR","city":"PHOENIX","state":"AZ","postal_code":"850122634","country_code":"US","street_2":"SUITE 200","phone":"6028082800"}],"license":{"state":"AZ","number":"OTC7723"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"494978","state":"AZ","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2015-07-28","last_updated":"2024-07-17","_meta":{"source":"NPPES","snapshot_date":"2024-07-17","doc_url":"https://findmynpi.com/api"}}