Mental Health Wellness Boutique

NPI Registration Record

Provider / Organization	NPI	Date Certified
MENTAL HEALTH WELLNESS BOUTIQUE	1972266757	2024-08-11

The organization Mental Health Wellness Boutique is registered with the National Plan and Provider Enumeration System (NPPES) and has the assigned NPI of 1972266757. Registration indicates Mental Health Wellness Boutique is a provider of services with a specialization in Ambulatory Health Care Facilities, Clinic/Center (Clinic/Center: Mental Health (Including Community Mental Health Center),, ) (Community Mental Health Center, ) (Clinic/Center Mental Health (Including Community Mental Health Center),, Ambulatory Health Care Facilities) (Clinic/Center, )

Entity Type	Organization

Provider Organization	MENTAL HEALTH WELLNESS BOUTIQUE
Practice Office Address	18001 N 79TH AVE STE B48 GLENDALE, AZ US
Practice Office Telephone	8889068301
Practice Office Fax	6234046602
Mailing Address	18001 N 79TH AVE STE B48 GLENDALE, AZ 853088393 US
Business Telephone	8889068301
Business Fax	6234046602
Authorized Official	IRINA ASHAMALLA, CEO 8889068301

Offices / Locations

Address	City / State	Phone / Fax
20403 N Lake Pleasant Rd Ste 117- 415	Peoria, AZ 85382	8889068301 / 6234046602

Contact Endpoints

Other URL []

AthenaHealth

HPT Codes

Code	Practice	License No State
261QM0801X PRIMARY	Ambulatory Health Care Facilities Clinic/Center Clinic/Center: Mental Health (Including Community Mental Health Center), Community Mental Health Center Clinic/Center Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities Clinic/Center

OPI Codes

1205365772

OTHER

INDIVIDUAL NPI

There has been an issue connecting to the database. The bells are ringing and alarms are sounding. Please try again in a few short minues and hopefully the problem will be resolved.SQLSTATE[HY000] [2002] Connection refused