Healthcare Provider Details

I. General information

NPI: 1114793510
Provider Name (Legal Business Name): NAFFA WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 09/06/2025
Certification Date: 09/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 W SOUTHERN AVE STE 124
MESA AZ
85210-5027
US

IV. Provider business mailing address

525 W SOUTHERN AVE STE 100
MESA AZ
85210-5009
US

V. Phone/Fax

Practice location:
  • Phone: 480-833-5007
  • Fax:
Mailing address:
  • Phone: 480-833-5007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KARRA PAPA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 480-536-8881