Evmark Corp

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ALH-1203 Issued in AZ

Legal business name

EVMARK CORP

Doing business as

Extended Family Assisted Living Homes

Practice address

2556 E Hermosa Vista Dr
Mesa, AZ 85213-2304

Phone

(480) 833-6328

NPI assigned

Mar 27, 2013

Organization subpart

No

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

Authorized official

Name

Marta C Logan

Title

Executive Director

Phone

(480) 833-6328

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Extended Family Assisted Living Homes Doing business as

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364342400000",
    "number": "1912240938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1942 N CALLE MADERAS",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852132908",
            "telephone_number": "480-833-6328",
            "fax_number": "480-827-9178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2556 E HERMOSA VISTA DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852132304",
            "telephone_number": "480-833-6328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVMARK CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-27",
        "last_updated": "2013-03-27",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "MARTA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "480-833-6328"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "ALH-1203",
            "primary": true
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "AL4343H",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219747",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219819",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Extended Family Assisted Living Homes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 Mar 27, 2013; 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.