NPIMap

Organization Active NPI

Goldfield Mountain Healthcare LLC

  • Assisted Living Facility
  • Mesa, AZ
National Provider Identifier
1770043630
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
GOLDFIELD MOUNTAIN HEALTHCARE LLC
Practice address
5848 E University Dr
Mesa, AZ 85205-7443
Phone
(480) 981-0098
Fax
(480) 396-3023
NPI assigned
Mar 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Soon Burnam
Title
Treasurer
Phone
(949) 540-1249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

5848 E University Dr
Mesa, AZ 85205-7443

Mailing address

5848 E University Dr
Mesa, AZ 85205-7443
Phone (480) 981-0098

National Provider Directory

National Provider Directory
Tax ID family
Alta Mesa Health and Rehabilitation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1553472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1770043630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5848 E UNIVERSITY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852057443",
            "telephone_number": "480-981-0098",
            "fax_number": "480-396-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5848 E UNIVERSITY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852057443",
            "telephone_number": "480-981-0098",
            "fax_number": "480-396-3023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDFIELD MOUNTAIN HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-25",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "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 Jul 20, 2022; 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.