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Organization
XOLA BEHAVIORAL HEALTH AND WELLNESS CENTER
Active
Organization
XOLA BEHAVIORAL HEALTH AND WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS LASSITER (MANAGING DIRECTOR)
(480) 242-8539
Entity
Organization
Contact information
Practice address
637 W OCOTILLO ST, CASA GRANDE, AZ 85122-2210
(480) 242-8539
Mailing address
637 W OCOTILLO ST, CASA GRANDE, AZ 85122-2210
(480) 242-8539
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
103TP0016X
Prescribing (Medical) Psychologist
—
NULL
103TP0016X
Prescribing (Medical) Psychologist
—
—
171400000X
Health & Wellness Coach
—
NULL
171400000X
Health & Wellness Coach
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
—
NULL
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
—
—
364SP0810X
Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
—
NULL
364SP0810X
Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Enumeration date
06/16/2025
Last updated
06/17/2025
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