Healthcare Provider Details

I. General information

NPI: 1306627252
Provider Name (Legal Business Name): HEALTHY ENDEAVORS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2023
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 W BASELINE RD STE 102183
MESA AZ
85210-6031
US

IV. Provider business mailing address

550 W BASELINE RD STE 102183
MESA AZ
85210-6031
US

V. Phone/Fax

Practice location:
  • Phone: 602-688-4191
  • Fax: 480-780-0665
Mailing address:
  • Phone: 602-688-4191
  • Fax: 480-780-0665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: REBECCA GASSETT
Title or Position: OWNER/PROVIDER
Credential: PNP
Phone: 602-688-4191