Healthcare Provider Details

I. General information

NPI: 1043152465
Provider Name (Legal Business Name): SANA HEALTH AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4433 N 19TH AVE STE 101
PHOENIX AZ
85015-4137
US

IV. Provider business mailing address

4433 N 19TH AVE STE 101
PHOENIX AZ
85015-4137
US

V. Phone/Fax

Practice location:
  • Phone: 773-312-2637
  • Fax:
Mailing address:
  • Phone: 773-312-2637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: BEN MUGABO
Title or Position: ADMINISTRATOR
Credential:
Phone: 773-312-2637