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NPI Code Detail

MEDICARE: ASANTE OF MESA, LLC

MEDICARE: ASANTE OF MESA, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing FacilityAL1573CAZ

General Provider Information

NPI Number : 1407152812
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASANTE OF MESA, LLC
Provider Business Mailing Address
First Line : 5358 EAST BASELINE ROAD
Second Line :
City : MESA
State : AZ
Zip : 85206
Country : US
Telephone Number : 480-699-9624
Fax Number : 480-699-8681
Provider Business Practice Location Address
First Line : 5358 EAST BASELINE ROAD
Second Line :
City : MESA
State : AZ
Zip : 85206-4716
Country : US
Telephone Number : 480-699-9624
Fax Number : 480-699-8681
Authorized Official
Title or Position : EXECUTIVE VP
Name : JACOB SCHAEFER
Credential :
Telephone Number : 503-201-8356
Provider Enumeration Date : 02/02/2011
Last Update Date : 12/13/2024

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Directions to “ASANTE OF MESA, LLC ” Practice Location

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