Mara Villa Care Center, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NCI2644 Issued in AZ

Legal business name

MARA VILLA CARE CENTER, INC.

Practice address

8825 S 7TH St
Phoenix, AZ 85042-7626

Phone

(602) 243-6121

Fax

(602) 276-7390

NPI assigned

Aug 22, 2005

Organization subpart

No

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

Authorized official

Name

Gary R Trebert

Title

Ceo

Phone

(817) 359-2000

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992797294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155635",
            "address_2": "STE 400",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761550635",
            "telephone_number": "817-359-2000",
            "fax_number": "817-359-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8825 S 7TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850427626",
            "telephone_number": "602-243-6121",
            "fax_number": "602-276-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARA VILLA CARE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TREBERT",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-359-2000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AZ",
            "license": "NCI2644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "882250",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lucinda Mapalo
• Briane Jeniene Mape, DNP, FNP-BC
• Jamie Mapes, RN
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• Mara Psychotherapy Group, LLC
• Kathryn Maria Maragioglio, MA, CCC-SLP
• Karina Annette Maralit
• Antonette Marie Marando, FNP-BC, MSN
• Tamara Sue Marano, OTR/L
• Susan Maranto, COTA/L

• Skilled Nursing Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Skilled Nursing Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.