HERITAGE VILLAGE BLDG5 LLC NPI 1467962506

NPI Information

NPI: 1467962506
Provider Name: HERITAGE VILLAGE BLDG5, LLC
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 03D2137204

Address:
8035 E BROWN RD
MESA, AZ
ZIP 85207
Phone: (480) 686-8540
Get Directions

HERITAGE VILLAGE BLDG5, LLC is an assisted living facility in Mesa, AZ. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. HERITAGE VILLAGE BLDG5, LLC NPI is 1467962506. The provider is registered as an organization entity type.

The provider's business location address is:

8035 E BROWN RD
MESA, AZ
ZIP 85207-901
Phone: (480) 686-8540

The provider's authorized official is Ron Stewart .
The authorized official title is Manager and has the following contact phone number (253) 241-4992.

The CLIA number assigned to this NPI record is 03D2137204 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/3/2017 and was last updated on 10/3/2017.

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	310400000X	Assisted Living Facility		AL10535C	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: 11/14/2023

NPI Synchronization or Removal

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