Healthcare Provider Details

I. General information

NPI: 1669302626
Provider Name (Legal Business Name): WHITESTONE COTTAGE LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5037 E BROADWAY RD
MESA AZ
85206-1301
US

IV. Provider business mailing address

5037 E BROADWAY RD
MESA AZ
85206-1301
US

V. Phone/Fax

Practice location:
  • Phone: 480-924-4073
  • Fax: 480-396-0191
Mailing address:
  • Phone: 480-924-4073
  • Fax: 480-396-0191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: NORA NIXON
Title or Position: EXECUTIVE DIRECTOR
Credential: LICENSED MANAGER
Phone: 928-710-5094