# MOHAVE HEALTH AND WELLNESS CENTER LLC

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

## Provider details

- **NPI number:** 1346932811
- **Authorized official:** SHANESE DIAMOND (OWNER)
- **Authorized official phone:** (480) 521-9859

## Contact information

- **Practice address:** 1940 MESQUITE AVE STE P-1, LAKE HAVASU CITY, AZ 86403-6123
- **Practice address phone:** (602) 706-4405
- **Mailing address:** 1940 MESQUITE AVE STE P-1, LAKE HAVASU CITY, AZ 86403-6123

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/23/2023
- **Last updated:** 01/25/2024