Village Mentors

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

VILLAGE MENTORS

Practice address

4903 E Dixon Cir
Mesa, AZ 85205-6453

Phone

(480) 313-4770

NPI assigned

Nov 27, 2019

Last updated

Nov 27, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jermaine Jordan, MBA

Title

Ceo

Phone

(480) 313-4770

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574812800000",
    "number": "1457997280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4903 E DIXON CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852056453",
            "telephone_number": "480-313-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4903 E DIXON CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852056453",
            "telephone_number": "480-313-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE MENTORS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-27",
        "last_updated": "2019-11-27",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "JERMAINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-313-4770",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Vilders, FNP
• Villa Alba Corporation (DBA: Americare Hospice & Palliative Care)
• Villa Minch, LLC
• Villa Tejada LLC (Holy Cross Hospice)
• Jordan D Villa, PA-C
• Benita Villalino, LCSW
• Misty Villar
• Villaraza Corporation (DBA: Victory Home Care Agency)
• Melinda Villarreal
• Virna Liza Villas, DDS

• Developmental Disabilities Clinic/Center in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Developmental Disabilities Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; 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.