# XOLA BEHAVIORAL HEALTH AND WELLNESS CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295621464
- **Authorized official:** CARLOS LASSITER (MANAGING DIRECTOR)
- **Authorized official phone:** (480) 242-8539

## Contact information

- **Practice address:** 637 W OCOTILLO ST, CASA GRANDE, AZ 85122-2210
- **Practice address phone:** (480) 242-8539
- **Mailing address:** 637 W OCOTILLO ST, CASA GRANDE, AZ 85122-2210
- **Mailing address phone:** (480) 242-8539

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |
| 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