Life Sonoran Homnes

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

LIFE SONORAN HOMNES

Practice address

2036 E Calle Maderas
Mesa, AZ 85213-2910

Phone

(480) 650-6685

Fax

(480) 461-0069

NPI assigned

Dec 16, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Mike FitzgeraldNPI 1811248305

Title

Manager

Phone

(480) 650-6685

Specialties & licenses 1

Addresses

Practitioners 1

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

• Mike Fitzgerald

  • Community Health Worker
  • Mesa, AZ
  • NPI 1811248305
  NPD (past) Authorized official

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

{
    "created_epoch": "1323993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323993600000",
    "number": "1114296332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8998",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852148998",
            "telephone_number": "480-650-6685",
            "fax_number": "480-461-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2036 E CALLE MADERAS",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852132910",
            "telephone_number": "480-650-6685",
            "fax_number": "480-461-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE SONORAN HOMNES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-16",
        "last_updated": "2011-12-16",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-650-6685",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Mesa, AZ
• Adult Care Home Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.