Mesa Grande Senior Living, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MESA GRANDE SENIOR LIVING, INC.

Doing business as

The Citadel Assisted Living Facility

Practice address

520 S Higley Rd
Mesa, AZ 85206-2153

Phone

(480) 832-7600

NPI assigned

Oct 3, 2017

Organization subpart

No

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

Authorized official

Name

Lee Johnson

Title

Treasurer

Phone

(208) 401-1369

Specialties & licenses 1

Addresses

Other names 1

• The Citadel Assisted Living Facility Doing business as

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579737600000",
    "number": "1679083703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S HIGLEY RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062153",
            "telephone_number": "480-832-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S HIGLEY RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062153",
            "telephone_number": "480-832-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA GRANDE SENIOR LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-03",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "208-401-1369"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Citadel Assisted Living Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mesa Family Physicians, PLC
• Mesa Family Therapy LLC
• Mesa Gastrointestinal Assoc PC
• Mesa General Emergency Physicians, LLC
• Mesa Grand Kids Dentistry and Orthodontics Az LLP
• Mesa Health and Community Resource Center LLC
• Mesa Health and Wellness Center
• Mesa Health Improvement Center
• Mesa Health Improvement Center, LLC
• Mesa Hospitalist PLLC

• Assisted Living Facility in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.