BREA EAST MESA LLC NPI 1740322114

NPI Information

NPI: 1740322114
Provider Name: BREA EAST MESA, LLC

Doing Business As: BROOKDALE EAST MESA

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

Address:
6145 EAST ARBOR AVENUE
MESA, AZ
ZIP 85206
Phone: (480) 832-1300
Get Directions

BREA EAST MESA, 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. BREA EAST MESA, LLC NPI is 1740322114. The provider is registered as an organization entity type.
The provider Is Doing Business As Brookdale East Mesa.

The provider's business location address is:

6145 EAST ARBOR AVENUE
MESA, AZ
ZIP 85206
Phone: (480) 832-1300
Fax: (480) 832-1370

The provider's authorized official is Bryan Richardson .
The authorized official title is Evp, Chief Admin. Officer and has the following contact phone number (615) 564-8131.

The CLIA number assigned to this NPI record is 03D0946498 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/13/2007 and was last updated on 6/13/2016.

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	License Number	License State	Primary
1	311500000X	Alzheimer Center (Dementia Center)	ALC-4498	ARIZONA	No
2	310400000X	Assisted Living Facility	ALC-6785	ARIZONA	No
3	310400000X	Assisted Living Facility	AL6354C	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	205629	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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