LEGACY VILLAGE OF EAST MESA NPI 1437377207

NPI Information

NPI: 1437377207
Provider Name: LEGACY VILLAGE OF EAST MESA
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
5037 E. BROADWAY
MESA, AZ
ZIP 85206
Phone: (480) 924-4073
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LEGACY VILLAGE OF EAST MESA is a community based residential treatment facility mental illness in Mesa, AZ. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. LEGACY VILLAGE OF EAST MESA NPI is 1437377207. The provider is registered as an organization entity type.

The provider's business location address is:

5037 E. BROADWAY
MESA, AZ
ZIP 85206
Phone: (480) 924-4073
Fax: (480) 396-0191

The provider's authorized official is Robert Thomas Bartel .
The authorized official title is Director and has the following contact phone number (480) 924-4073.

The enumeration date for this NPI number is 4/24/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness		ALC5776	ARIZONA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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