Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blooming Agave Wellness LLC

Organization Adult Mental Health Clinic/Center · NPI 1053144154

Blooming Agave Wellness LLC is an Adult Mental Health Clinic/Center in Phoenix, Arizona. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4117 N 17th St
Phoenix, AZ 85016-5921
Phone: (623) 239-2312
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Mental Health Clinic/Center (primary) Taxonomy 261QM0850X

Record details

NPI number1053144154
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joshua Phillips — Therapist/Owner · (970) 260-8286
NPI enumeratedAugust 23, 2024
Last updated in NPPESAugust 23, 2024
Certification dateAugust 23, 2024
Mailing address16609 N 34th Pl, Phoenix, AZ 85032-2776

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