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Organization

MINDFUL WELLNESS OF AZ LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WELLENGTEN JENKINS (MANAGING PARTNER)
(602) 421-6661
Entity
Organization

Contact information

Practice address
8751 N 51ST AVE STE 108, GLENDALE, AZ 85302-4943
(520) 329-5283
Mailing address
8751 N 51ST AVE STE 108, GLENDALE, AZ 85302-4943
(520) 329-5283

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
Primary
253Z00000X
In Home Supportive Care Agency
261QC1500X
Community Health Clinic/Center
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QR0800X
Recovery Care Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
874442042
AZ
Enumeration date
04/28/2022
Last updated
04/28/2022
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