MRSC AZ MESA MASTER TENANT LLC NPI 1497209647

NPI Information

  • NPI: 1497209647
  • Provider Name: MRSC AZ MESA MASTER TENANT, LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • :
  • CLIA Number: 03D2115825
  • Address: 537 S HIGLEY RD BLDG 1
    MESA, AZ
    ZIP 85206
  • Phone: (480) 247-9880

Map and Directions

Get Directions

NPI Details

MRSC AZ MESA MASTER TENANT, 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. MRSC AZ MESA MASTER TENANT, LLC NPI is 1497209647. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

537 S HIGLEY RD BLDG 1
MESA, AZ
ZIP 85206-148
Phone: (480) 247-9880

The provider's authorized official is Gary Langendoen .
The authorized official title is Co-manager and has the following contact phone number (626) 796-8700.

The CLIA number assigned to this NPI record is 03D2115825 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/4/2016 and was last updated on 2/5/2025.

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
1310400000XAssisted Living FacilityAL10068CARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1149133MEDICAIDARIZONA
2149278MEDICAIDARIZONA

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: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI