Mesa Serenity Assisted Living Home LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MESA SERENITY ASSISTED LIVING HOME LLC

Practice address

3759 E Clovis Ave
Mesa, AZ 85206-1841

Phone

(480) 646-2772

Fax

(480) 597-3303

NPI assigned

May 16, 2024

Organization subpart

No

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

Authorized official

Name

Jovy AvilaNPI 1740852391

Title

Owner/Administrator

Phone

(480) 646-2772

Specialties & licenses 1

Addresses

Other names 1

• MESA SERENITY ASSISTED LIVING HOME LLC Doing business as

Locations

Practitioners 1

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

• Jovy Avila

  • Assisted Living Facility
  • Mesa, AZ
  • NPI 1740852391
  NPD Authorized official

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1992554455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 N ARIZONA AVE UNIT 1365",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852250716",
            "telephone_number": "480-646-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3759 E CLOVIS AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061841",
            "telephone_number": "480-646-2772",
            "fax_number": "480-597-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA SERENITY ASSISTED LIVING HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A",
        "authorized_official_last_name": "AVILA",
        "authorized_official_first_name": "JOVY",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "480-646-2772"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MESA SERENITY ASSISTED LIVING HOME LLC",
            "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 May 16, 2024; 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.