Healthcare Provider Details

I. General information

NPI: 1992642540
Provider Name (Legal Business Name): EVERWELL INTEGRATED HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9014 S CENTRAL AVE
PHOENIX AZ
85042-8304
US

IV. Provider business mailing address

9014 S CENTRAL AVE
PHOENIX AZ
85042-8304
US

V. Phone/Fax

Practice location:
  • Phone: 623-215-3441
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FUNMILOLA OGUNLA
Title or Position: DIRECTOR
Credential:
Phone: 602-628-2266