Healthcare Provider Details

I. General information

NPI: 1053368589
Provider Name (Legal Business Name): MESA HEALTH IMPROVEMENT CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6343 E MAIN ST SUITE 8
MESA AZ
85205-8954
US

IV. Provider business mailing address

6343 E MAIN ST SUITE 8
MESA AZ
85205-8954
US

V. Phone/Fax

Practice location:
  • Phone: 480-325-8838
  • Fax: 480-325-9191
Mailing address:
  • Phone: 480-325-8838
  • Fax: 480-325-9191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberOTC3115
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License NumberOTC3115
License Number StateAZ

VIII. Authorized Official

Name: MR. MARC ELLIOTT RUBENSTEIN
Title or Position: CEO
Credential:
Phone: 480-325-8838