Villa Tejada LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

VILLA TEJADA LLC

Practice address

6124 E Brown Rd
Ste 101
Mesa, AZ 85205-4959

Phone

(480) 718-5678

Fax

(480) 718-5697

NPI assigned

Jul 19, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Eva Tejada

Title

Cfo

Phone

(480) 262-2464

Specialties & licenses 1

Addresses

Other names 1

• Holy Cross Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Hospice certification: CCN 031671

Legal name

VILLA TEJADA LLC

Doing business as

HOLY CROSS HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jun 16, 2017

Last certification

Jun 14, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

Mar 22, 2016 in AZ

Enrollment address

1103 S Mesa Dr
Mesa, AZ 85210-8722

Listed as

Holy Cross HospiceCCN 031671

Ownership

For-Profit

Certified

Jun 16, 2017

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Richard W Moos, MD PC

  • Obstetrics & Gynecology Physician
  • Scottsdale, AZ
  • NPI 1033100821

  Contracted Managing Employee, Corporate Director

  CMS ownership

Practitioners 2

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

• Robert Brian Tejada

  • Family Nurse Practitioner
  • Chandler, AZ
  • NPI 1407481013
  NPD
• Eva Lorane Ward

  • Student in an Organized Health Care Education/Training Program
  • Mesa, AZ
  • NPI 1437981214
  NPD

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Ashley Archer, NP-C

  • Family Nurse Practitioner
  • Mesa, AZ
  • NPI 1609350271

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468886400000",
    "number": "1386097905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21975",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852771975",
            "telephone_number": "480-718-5678",
            "fax_number": "480-718-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6124 E BROWN RD",
            "address_2": "STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852054959",
            "telephone_number": "480-718-5678",
            "fax_number": "480-718-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA TEJADA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-19",
        "last_updated": "2016-07-19",
        "status": "A",
        "authorized_official_last_name": "TEJADA",
        "authorized_official_first_name": "EVA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "480-262-2464",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holy Cross Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Arnaldo Vigo-Morales, LCSW
• Vijay S Gill M D P C
• Jennifer Lynn Vilders, FNP
• Villa Alba Corporation
• Villa Minch, LLC
• Jordan D Villa, PA-C
• Village Mentors
• Benita Villalino, LCSW
• Misty Villar
• Villaraza Corporation

• Community Based Hospice Care Agency in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Community Based Hospice Care Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.