NPIMap

Organization Active NPI

Mesa Development Sub, LLC

  • Psychiatric Hospital
  • Mesa, AZ
National Provider Identifier
1013789668
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
MESA DEVELOPMENT SUB, LLC
Practice address
3322 South Ellsworth Rd
Mesa, AZ 85212
Phone
(623) 254-7220
NPI assigned
Oct 26, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brian P. Farley
Title
Vice President and Secretary
Phone
(615) 861-6000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Psychiatric Hospital 283Q00000X Primary

Addresses

Primary practice location

3322 South Ellsworth Rd
Mesa, AZ 85212

Mailing address

4020 Aspen Grove Dr Ste 900
Franklin, TN 37067-3134
Phone (615) 861-6000

Other practice location 1

3322 S Ellsworth Rd Ste B
Mesa, AZ 85212-2730
Phone (623) 254-7220

Other names 1

  • Agave Ridge Behavioral Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240306001539 AZ Part A Provider - Hospital 7315383957 Practice locations: Mesa, AZ
O20250219003072 AZ Part B Supplier - Clinic/Group Practice 7315383957 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Mesa, AZ

Hospital certification: CCN 034041

Legal name
MESA DEVELOPMENT SUB LLC
Doing business as
AGAVE RIDGE BEHAVIORAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Aug 15, 2024
Last certification
Aug 15, 2024
Beds
100
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Enrollment address
3322 S Ellsworth Rd
Mesa, AZ 85212-2730
Main/Primary Hospital Location
Hospital subgroups
Psychiatric

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Agave Ridge Behavioral HospitalCCN 034041
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Mesa Development Sub LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3322 S Ellsworth Rd
Ste B
Mesa, AZ 85212
Phone (623) 254-7220

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jennifer Nunez Individual W-2 Managing EmployeeFacility Ceo Jan 1, 2024
Deborah S Kraemer Individual W-2 Managing EmployeeVice President of Business Opera Sep 8, 2022
Todd S Young Individual Corporate OfficerVice President & Treasurer Oct 27, 2025
Acadia Healthcare Company Inc Organization, Franklin, TN Corporation, For-profit, Chain home office 5% Or Greater Direct Ownership Interest Sep 8, 2022 100%
Stacie L Harty Individual W-2 Managing EmployeeVice President of Managed Care Sep 8, 2022
Brian Philip Farley Individual Corporate OfficerVice President & Ceo Jul 26, 2023
Timothy a Sides Individual W-2 Managing EmployeeSenior VP Operations & Finance Jun 5, 2023
Debra K Osteen Individual Corporate OfficerPresident Jan 20, 2026

Facilities with the same owner 59

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 59

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1698278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767052800000",
    "number": "1013789668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 ASPEN GROVE DR STE 900",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370673134",
            "telephone_number": "615-861-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 SOUTH ELLSWORTH RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85212",
            "telephone_number": "623-254-7220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3322 S Ellsworth Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852122730",
            "country_code": "US",
            "telephone_number": "623-254-7220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MESA DEVELOPMENT SUB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-26",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A",
        "authorized_official_last_name": "FARLEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "VICE PRESIDENT AND SECRETARY",
        "authorized_official_telephone_number": "615-861-6000"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agave Ridge Behavioral Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Agave Ridge Behavioral Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.