Organization · NPI-2

215 West Brown Road Operations LLC

Assisted Living Facility · Mesa, AZ

NPI number1669952982
StatusActive
Last updated in NPPESAug 16, 2018

Details

NPI
1669952982
Entity type
Organization (NPI-2)
Legal business name
215 West Brown Road Operations LLC
Organization subpart
No
Enumeration date
Aug 16, 2018
Last updated
Aug 16, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
310400000X Assisted Living Facility––Yes

Other names

  • Mesa Christian Residential Care Center (Doing Business As)

Practice location

215 W Brown Rd
Mesa, AZ 85201

Phone 480-461-1552

Mailing address

101 E State St
Kennett Square, PA 19348-3109

Phone 610-925-2254

Authorized official

Michael Berg
Assistant Secretary
5054684742

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