LEGACY VILLAGE OF EAST MESA (NPI# 1437377207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1437377207 |
Entity Type | Organization |
Organization Name | LEGACY VILLAGE OF EAST MESA |
Practice Address |
5037 E. Broadway Mesa AZ 85206 |
Mailing Address |
5037 E Broadway Rd Mesa AZ 85206-1301 |
Practice Telephone | 4809244073 |
Practice Fax Number | 4803960191 |
Mailing Telephone | 4809244073 |
Mailing Fax Number | 4803960191 |
Enumeration Date | 2007-04-24 |
Last Update Date | 2020-08-22 |
Authorized Official Name | MR. ROBERT THOMAS BARTEL (DIRECTOR) |
Authorized Official Telephone | 4809244073 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | ALC5776 | AZ | Residential Treatment Facilities |
Street Address |
5037 E. BROADWAY |
City | MESA |
State | AZ |
Zip Code | 85206 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720693062 | Inner Balance Counseling LLC | Counselor | 4111 E Auto Valley Drive, Suite 101, Mesa, AZ 85206 | 2020-09-14 |
1356978969 | Choices 4 Change Counseling and Coaching LLC | Social Worker | 3707 E Southern Ave., Suite 2027, Mesa, AZ 85206 | 2020-03-24 |
1023651288 | Jason Mcclure | Hearing Instrument Specialist | 5540 E Broadway Rd., Mesa, AZ 85206 | 2019-10-21 |
1255995361 | Vhs of Phoenix Inc | General Acute Care Hospital | 5750 E. Baseline Rd., Mesa, AZ 85206 | 2019-04-24 |
1932682184 | Adam Fishel Frose | Psychologist | 4555 E Inverness Ave Ste 112, Mesa, AZ 85206 | 2018-09-13 |
1376024737 | Robyn Kathleen Hall | Psychologist | 4115 East Valley Auto Drive, Suite 208, Mesa, AZ 85206 | 2018-08-23 |
1790264984 | Perspective Health, LLC | Clinic/Center | 1959 S. Power Rd, Suite 103, #206, Mesa, AZ 85206 | 2018-08-09 |
1033605159 | Rebecca Ann Maro | Nurse Practitioner | 6750 E Baywood Ave Ste 502, Mesa, AZ 85206 | 2018-07-02 |
1982195624 | Spark Performance and Physiotherapy | Clinic/Center | 6056 East Basline Road, Suite 147, Mesa, AZ 85206 | 2018-05-29 |
1336645993 | Ashley Wright | Audiologist-Hearing Aid Fitter | 1423 S Higley Rd Ste 119, Mesa, AZ 85206 | 2018-04-03 |
Find all providers in zip 85206 |
Taxonomy Code | 320800000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment Facility, Mental Illness |
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144835968 | Jfox II LLC | Community Based Residential Treatment Facility, Mental Illness | 5327 E Enrose Cir, Mesa, AZ 85205-5489 | 2020-09-09 |
1356987119 | Healthy Minds of Arizona | Community Based Residential Treatment Facility, Mental Illness | 2735 E Main St Ste 1, Mesa, AZ 85213-9269 | 2019-11-26 |
1174166136 | Harmony Care, LLC | Community Based Residential Treatment Facility, Mental Illness | 2726 S Los Altos, Mesa, AZ 85202-7326 | 2019-10-22 |
1700445657 | The Nile Health Network | Community Based Residential Treatment Facility, Mental Illness | 1367 S Country Club Dr Unit 1011, Mesa, AZ 85210-5155 | 2019-06-12 |
1780177535 | Legacy Senior Management LLC | Community Based Residential Treatment Facility, Mental Illness | 152 N 56th St Ste B, Mesa, AZ 85205-8718 | 2018-06-07 |
1003344367 | Ptl Behavioral Health, LLC | Community Based Residential Treatment Facility, Mental Illness | 10839 E Sonrisa Ave, Mesa, AZ 85212-5126 | 2017-05-31 |
1811322795 | Pavillion | Community Based Residential Treatment Facility, Mental Illness | 963 E 9th Pl, Mesa, AZ 85203-5623 | 2013-09-10 |
1114272416 | Arizona Behavioral Care Homes LLC | Community Based Residential Treatment Facility, Mental Illness | 1024 N Ridge Cir, Mesa, AZ 85203-5129 | 2012-07-23 |
1992911226 | Marc Community Resources, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6433 E Quartz St, Mesa, AZ 85215-0948 | 2007-05-15 |
1215143540 | Marc Community Resources, Inc. | Community Based Residential Treatment Facility, Mental Illness | 2664 E Hermosa Vista Dr, Mesa, AZ 85213-2306 | 2007-05-15 |
Find all providers in MESA |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.