Third Street Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ALH-4846 Issued in AZ

Legal business name

THIRD STREET HOME

Practice address

1053 E 3Rd St
Mesa, AZ 85203-8001

Phone

(480) 610-6974

Fax

(480) 610-6974

NPI assigned

Jul 25, 2007

Organization subpart

No

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

Authorized official

Name

Amalia Simona Bondar

Title

Manager

Phone

(480) 610-6974

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1154511202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1053 E 3RD ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852038001",
            "telephone_number": "480-610-6974",
            "fax_number": "480-610-6974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1053 E 3RD ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852038001",
            "telephone_number": "480-610-6974",
            "fax_number": "480-610-6974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIRD STREET HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "BONDAR",
        "authorized_official_first_name": "AMALIA",
        "authorized_official_middle_name": "SIMONA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-610-6974"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "ALH-4846",
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "AZ",
            "license": "ALH-4846",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Therma-Scan Reference Laboratory, LLC
• Claude R Thibeault, MD
• Jeff R Thiboutot, B.S., C.N.
• Katherine Aubrey Thiel
• Maryann Beltran Thirakul, PSYD.
• Stephanie Marie Thirjung
• Elaine Thobe
• Thomas E Sutton MD PC
• Ashley Kay Thomas, CF-SLP
• Broch Thomas, D.M.D.

• Assisted Living Facility in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; 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.