Healthcare Provider Details

I. General information

NPI: 1801644521
Provider Name (Legal Business Name): THE STONE COMMUNITY HEALTH CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2024
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 N COUNTRY CLUB DR STE 45
MESA AZ
85201-5727
US

IV. Provider business mailing address

423 N COUNTRY CLUB DR STE 45
MESA AZ
85201-5727
US

V. Phone/Fax

Practice location:
  • Phone: 480-276-0689
  • Fax:
Mailing address:
  • Phone: 480-276-0689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LUC-ARMAND NINGUMIRIZE
Title or Position: MEMBER
Credential:
Phone: 480-276-0689