MRSC AZ MESA MASTER TENANT LLC NPI 1497209647

NPI Information

NPI: 1497209647
Provider Name: MRSC AZ MESA MASTER TENANT, LLC

Doing Business As: VISIONS SENIOR LIVING AT MESA 1

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

Address:
537 S HIGLEY RD BLDG 1
MESA, AZ
ZIP 85206
Phone: (480) 427-2797
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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 Is Doing Business As Visions Senior Living At Mesa 1.

The provider's business location address is:

537 S HIGLEY RD BLDG 1
MESA, AZ
ZIP 85206-148
Phone: (480) 427-2797

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

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 8/4/2016.

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		AL10068C	ARIZONA	Yes

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
1	149278	MEDICAID	ARIZONA
2	149133	MEDICAID	ARIZONA

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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