BREA EAST MESA, LLC
Alzheimer Center
Mesa, Arizona
Provider NPI: 1740322114
Organization Information:Organization Name: BREA EAST MESA, LLC
Practice Location:
6145 EAST ARBOR AVENUE MESA, AZ 85206 US
Tel: 480-832-1300 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
6145 EAST ARBOR AVENUE MESA, AZ 85206 US
Tel: 480-832-1300 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 311500000X | Nursing & Custodial Care Facilities Alzheimer Center (Dementia Center) | AZ | ALC-4498 |
N | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | AZ | ALC-6785 |
Y | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | AZ | AL6354C |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
205629 | AZ | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin