Healthcare Provider Details

I. General information

NPI: 1033958970
Provider Name (Legal Business Name): VIVABEST PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2024
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5654 W BELL RD STE C
GLENDALE AZ
85308-3882
US

IV. Provider business mailing address

5654 W BELL RD STE C
GLENDALE AZ
85308-3882
US

V. Phone/Fax

Practice location:
  • Phone: 480-803-1066
  • Fax:
Mailing address:
  • Phone: 480-803-1066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: FELIX IYINBOR OSAWARU
Title or Position: DIRECTOR
Credential: PMHNP
Phone: 518-316-9225