LEGACY VILLAGE OF EAST MESA


Address: 5037 E. Broadway, Mesa, AZ 85206
Phone: 4809244073

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320800000X Community Based Residential Treatment Facility, Mental Illness ALC5776 AZ Residential Treatment Facilities

Office Location

Street Address 5037 E. BROADWAY
City MESA
State AZ
Zip Code 85206

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 320800000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment Facility, Mental Illness

Taxonomy Definition

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

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
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Competitor

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City MESA
Zip Code 85206

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Dataset Information

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.

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