NPIMap

Organization Active NPI

Pride Family Ser

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Mesa, AZ
National Provider Identifier
1699378091
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X
Legal business name
PRIDE FAMILY SER
Practice address
1255 W Baseline Rd # C-175
Mesa, AZ 85202-5820
Phone
(408) 687-3620
Fax
(480) 687-3769
NPI assigned
Nov 18, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Authorized official

Name
Trandy HesterNPI 1851994461
Title
Ceo
Phone
(408) 687-3620

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Adult Mental Health Clinic/Center 261QM0850X
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X Primary

Addresses

Primary practice location

1255 W Baseline Rd # C-175
Mesa, AZ 85202-5820

Mailing address

1255 W Baseline Rd # C-175
Mesa, AZ 85202-5820
Phone (408) 687-3620

National Provider Directory

National Provider Directory

Locations

1255 W Baseline Rd
#C175
Mesa, AZ 85202
Phone (480) 687-3620

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615420800000",
    "number": "1699378091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 W BASELINE RD # C-175",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852025820",
            "telephone_number": "408-687-3620",
            "fax_number": "480-687-3769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 W BASELINE RD # C-175",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852025820",
            "telephone_number": "408-687-3620",
            "fax_number": "480-687-3769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIDE FAMILY SER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-18",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A",
        "authorized_official_last_name": "HESTER",
        "authorized_official_first_name": "TRANDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "408-687-3620"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "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 Mar 11, 2021; 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.