Organization Active NPI

Legacy Native Home Care LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Mesa, AZ
National Provider Identifier
1336011527
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
LEGACY NATIVE HOME CARE LLC
Practice address
5235 S Axiom
Mesa, AZ 85212-8529
Phone
(480) 245-4471
NPI assigned
Sep 18, 2025
Last updated
Sep 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Authorized official

Name
Tyrese M Tomegah
Title
Ceo
Phone
(480) 865-5244

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X NU Primary

Addresses

Primary practice location

5235 S Axiom
Mesa, AZ 85212-8529

Mailing address

5235 S Axiom
Mesa, AZ 85212-8529
Phone (480) 245-4471

National Provider Directory

National Provider Directory
Tax ID family
Legacy Native Home Care 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.

NPI Registry JSON

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

{
    "created_epoch": "1758153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1336011527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5235 S AXIOM",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852128529",
            "telephone_number": "480-245-4471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5235 S AXIOM",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852128529",
            "telephone_number": "480-245-4471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY NATIVE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-18",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "TOMEGAH",
        "authorized_official_first_name": "TYRESE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-865-5244"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; 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.