MEDICARE: EVERWELL INTEGRATED HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QP2300X	Primary Care Clinic/Center
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
3	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1992642540
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVERWELL INTEGRATED HEALTH LLC

Provider Business Mailing Address
First Line	:	9014 S CENTRAL AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-8304
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9014 S CENTRAL AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-8304
Country	:	US
Telephone Number	:	623-215-3441
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	FUNMILOLA OGUNLA
Credential	:
Telephone Number	:	602-628-2266

Provider Enumeration Date	:	05/01/2026
Last Update Date	:	05/01/2026

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