HERITAGE LIFE CENTER LLC (NPI# 1144452988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144452988 |
| Entity Type | Organization |
| Organization Name | HERITAGE LIFE CENTER LLC |
| Other Organization Name | COPPER LANE |
| Practice Address |
1041 S Lebaron Mesa AZ 85210-3630 |
| Practice Telephone | 4803078809 |
| Practice Fax Number | 4803078949 |
| Mailing Telephone | 4803078809 |
| Mailing Fax Number | 4803078949 |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2015-05-07 |
| Authorized Official Name | MR. REED T GUNNELL (OWNER) |
| Authorized Official Telephone | 4803078809 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | ALC-7160 | AZ | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Copper Lane | Doing Business As Name - Organization |
| Street Address |
1041 S LEBARON |
| City | MESA |
| State | AZ |
| Zip Code | 85210-3630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972553360 | Lana J. Peterson | Nurse Practitioner | 1041 S Lebaron, Mesa, AZ 85210-3630 | 2006-05-10 |
| 1134549579 | Pride Behavioral Health | Registered Nurse | 1041 S Lebaron, Mesa, AZ 85210-3630 | 2014-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497382501 | Mesa Center for Family Medicine | Internal Medicine | 2034 S Alma School Road, Suite #101, Mesa, AZ 85210 | 2020-03-26 |
| 1780177121 | Jessica Cannata | Speech-Language Pathologist | 2150 S Country Club Rd, Suite 20, Mesa, AZ 85210 | 2018-06-11 |
| 1831680305 | Alexandra Katherine Ebong | Nurse Practitioner | 1950 S. Country Club Drive, Ste 102, Mesa, AZ 85210 | 2018-05-21 |
| 1548762719 | Russell D. Meldrum, M.d. Pllc | Orthopaedic Surgery | 855 W. Southern Ave., #1114, Mesa, AZ 85210 | 2018-03-05 |
| 1023510435 | Denise M Bruno-krupp | Counselor | 1830 S. Alma School Rd. Suite 101, Mesa, AZ 85210 | 2018-03-01 |
| 1609374529 | Gene R Lullo | Social Worker | 1830 S Alma School Rd Suite 101, Mesa, AZ 85210 | 2018-01-25 |
| 1295264000 | Ashley P Smith | Naturopath | 601 S Alma School Rd, Apt 101, Mesa, AZ 85210 | 2017-06-06 |
| 1386184059 | Brittany Johnson | Counselor | 1745 S Alma School Rd Ste 230, Mesa, AZ 85210 | 2017-03-01 |
| 1487190880 | Mesa Valley Modern Dentistry, LLP | Dentist | 1712 S, Country Club Drive, Ste 104, Mesa, AZ 85210 | 2017-01-10 |
| 1821544529 | Sandra Coren | Licensed Practical Nurse | 32 S Mcdonald, Tlc, Mesa, AZ 85210 | 2016-09-01 |
| Find all providers in zip 85210 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710586664 | Sunland Springs Memory Care, LLC | Assisted Living Facility | 2415 S Signal Butte Rd, Mesa, AZ 85209-2107 | 2020-10-21 |
| 1487253860 | Ronald Jingco Calaguas | Assisted Living Facility | 2432 W Portobello Ave, Mesa, AZ 85202-7871 | 2020-10-18 |
| 1851905038 | A Helping Hand Care Home | Assisted Living Facility | 847 E Glade Ave, Mesa, AZ 85204-5813 | 2020-09-03 |
| 1699301341 | Arizona Home Care Spectrum Solutions II LLC | Assisted Living Facility | 8129 E Fountain St, Mesa, AZ 85207-4915 | 2020-03-13 |
| 1043858673 | Loving Hearts Assisted Living LLC | Assisted Living Facility | 1714 S Linda, Mesa, AZ 85204-7109 | 2019-12-13 |
| 1487203543 | Heritage Village Bldg 7 | Assisted Living Facility | 8035 E Brown Rd Bldg 7, Mesa, AZ 85207-3902 | 2019-09-10 |
| 1982253043 | Heritage Village Bldg 8 LLC | Assisted Living Facility | 8035 E Brown Rd Bldg 8, Mesa, AZ 85207-3902 | 2019-09-10 |
| 1487200481 | Royalty Home Care Solutions, LLC | Assisted Living Facility | 6551 E. Menlo St, Mesa, AZ 85215 | 2019-08-15 |
| 1386101822 | Assisted Senior Living Care, LLC | Assisted Living Facility | 4149 E Greenway Cir, Mesa, AZ 85205-4036 | 2019-02-20 |
| 1851803993 | Arizona Community Assisted Living Home, LLC. | Assisted Living Facility | 9952 E Butte St, Mesa, AZ 85207-8016 | 2017-10-30 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.