Healthcare Provider Details

I. General information

NPI: 1346153517
Provider Name (Legal Business Name): LUCID BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5529 E BLOOMFIELD RD
SCOTTSDALE AZ
85254-4203
US

IV. Provider business mailing address

7515 W ODEUM LN
PHOENIX AZ
85043-1238
US

V. Phone/Fax

Practice location:
  • Phone: 864-384-3082
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: RICHARD MUGABE
Title or Position: OWNER
Credential:
Phone: 864-384-3082