<Unavail>

LBN: Evergreen At Mesa, L.L.C.
<Unavail> is an health care organization with primary practice located at 6458 E Broadway Rd , Mesa AZ 85206-1727. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Evergreen At Mesa, L.L.C. can be contacted via phone (480) 832-5160, or through Martini, Andrew V. via phone (360) 892-6628.

Contact Information

Primary practice address
6458 E Broadway Rd Mesa AZ 85206-1727
Phone: (480) 832-5160
Fax: (480) 854-7046
Website:
Map and Directions
Authorized official contact:
Name: Martini, Andrew V.
Phone: (360) 892-6628

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X NCA-2627 Arizona

Profile Details

NPI number 1275581951
LBN Legal business name Evergreen At Mesa, L.L.C.
DBA Doing business as <Unavail>
Authorized official Martini, Andrew V.
Entity Organization
Organization subpart 1 No
Enumeration date May 4th, 2006
Last updated Aug 22nd, 2020 - about 6 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 1275581951 NPPES
Arizona MEDICAID 748767

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