Mesa Christian Residential Care Center

LBN: Evergreen At Mesa (Alf), L.L.C.
Mesa Christian Residential Care Center is an health care organization with primary practice located at 215 W Brown Rd , Mesa AZ 85201-3415. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. Evergreen At Mesa (Alf), L.L.C. can be contacted via phone (480) 668-6118, or through Nipp, Anne via phone (360) 892-6618.

Contact Information

Primary practice address
215 W Brown Rd Mesa AZ 85201-3415
Phone: (480) 668-6118
Fax: (480) 461-1552
Website:
Map and Directions
Authorized official contact:
Name: Nipp, Anne
Phone: (360) 892-6618

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X ALC-5063 Arizona

Profile Details

NPI number 1093914004
LBN Legal business name Evergreen At Mesa (Alf), L.L.C.
DBA Doing business as Mesa Christian Residential Care Center
Authorized official Nipp, Anne
Entity Organization
Organization subpart 1 No
Enumeration date Jul 11th, 2007
Last updated Jul 11th, 2007 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093914004 NPPES
Arizona MEDICAID 937427

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