412 Home LLC

Organization Active NPI Assisted Living Facility · Mesa, AZ

NPI 1245016344 · NPPES record last updated Sep 5, 2023

Key facts

NPI
1245016344
Entity type
Organization (NPI type 2)
Primary specialty
Assisted Living Facility 310400000X
Legal business name
412 HOME LLC
Practice address
412 S 30TH St
Mesa, AZ 85204-3111
Phone
(480) 584-5666
Fax
(480) 588-5460
NPI assigned
Sep 5, 2023
Organization subpart
No

Authorized official

Name
Chaim Zimmerman
Title
Manager
Phone
(480) 985-9695

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Yes

Addresses

Primary practice location

412 S 30TH St
Mesa, AZ 85204-3111

Mailing address

412 S 30TH St
Mesa, AZ 85204-3111
Phone (480) 584-5666

Other names

  • Jones Family Care Home Doing business as

Other providers in Mesa, AZ

All providers in Mesa, AZ · Assisted Living Facility in Arizona

Sources for this page

Verify at the official NPI Registry.