Sunrise Mesa Health Care Center Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NCI-416 Issued in AZ

Legal business name

SUNRISE MESA HEALTH CARE CENTER INC

Doing business as

Springdale West

Practice address

3130 E Broadway Rd
Mesa, AZ 85204-1740

Phone

(480) 924-7777

Fax

(480) 924-5712

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Linda L Carlson

Title

Chief Executive Officer

Phone

(480) 924-7777

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Springdale West Doing business as

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265543607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 E BROADWAY RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852041740",
            "telephone_number": "480-924-7777",
            "fax_number": "480-924-5712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 E BROADWAY RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852041740",
            "telephone_number": "480-924-7777",
            "fax_number": "480-924-5712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE MESA HEALTH CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "480-924-7777"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AZ",
            "license": "NCI-416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041468",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Springdale West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Skilled Nursing Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.