SOBA MESA LLC (NPI# 1144670951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1144670951 |
Entity Type | Organization |
Organization Name | SOBA MESA LLC |
Practice Address |
6262 E Broadway Rd Mesa AZ 85206-6101 |
Practice Telephone | 4806644053 |
Enumeration Date | 2016-06-13 |
Last Update Date | 2016-06-13 |
Authorized Official Name | MICHELLE JOHNS (ACCOUNT EXECUTIVE) |
Authorized Official Telephone | 3104572730 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
OTC6989 | AZ | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | CLIA | 03D2084103 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326491283 | Soba Mesa LLC | Substance Abuse Rehabilitation Facility | 6215 E Arbor Ave, Mesa, AZ 85206-6064 | 2016-07-15 |
1063865921 | Soba Mesa LLC | Clinical Medical Laboratory | 6215 E Arbor Ave, Mesa, AZ 85206-6064 | 2016-07-15 |
1629489513 | Soba Mesa LLC | Substance Abuse Rehabilitation Facility | 3755 E Menlo St, Mesa, AZ 85215-1717 | 2014-05-13 |
Street Address |
6262 E BROADWAY RD |
City | MESA |
State | AZ |
Zip Code | 85206-6101 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780682666 | Robert J Scharber | Audiologist | 6262 E Broadway Rd, #103, Mesa, AZ 85206-6101 | 2005-07-13 |
1538688841 | Danielle N Olin | Counselor | 6262 E Broadway Rd, Mesa, AZ 85206-6101 | 2017-09-18 |
1548707839 | Christina Kennedy | Marriage & Family Therapist | 6262 E Broadway Rd, Mesa, AZ 85206-6101 | 2017-01-24 |
1366895427 | Jackie Powell | Counselor | 6262 E Broadway Rd, Suite 101, Mesa, AZ 85206-6101 | 2016-07-13 |
1235580713 | David Emenhiser | Counselor | 6262 E Broadway Rd, Suite 101, Mesa, AZ 85206-6101 | 2016-06-27 |
1336590942 | Lisa Ulibarri | Counselor | 6262 E Broadway Rd, Mesa, AZ 85206-6101 | 2016-06-24 |
1578880720 | John Gossett | Social Worker | 6262 E Broadway Rd, Mesa, AZ 85206-6101 | 2010-04-28 |
1215083506 | The Retina Group, Pllc | Ophthalmology | 6262 E Broadway Rd, Ste 106, Mesa, AZ 85206-6101 | 2007-01-27 |
1689648875 | Alyssa Kim | Ophthalmology | 6262 E Broadway Rd, Suite 106, Mesa, AZ 85206-6101 | 2006-02-14 |
1598763484 | East Valley Hearing Center Inc | Audiologist | 6262 E Broadway Rd, #103, Mesa, AZ 85206-6101 | 2005-07-13 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720693062 | Inner Balance Counseling LLC | Counselor | 4111 E Auto Valley Drive, Suite 101, Mesa, AZ 85206 | 2020-09-14 |
1356978969 | Choices 4 Change Counseling and Coaching LLC | Social Worker | 3707 E Southern Ave., Suite 2027, Mesa, AZ 85206 | 2020-03-24 |
1023651288 | Jason Mcclure | Hearing Instrument Specialist | 5540 E Broadway Rd., Mesa, AZ 85206 | 2019-10-21 |
1255995361 | Vhs of Phoenix Inc | General Acute Care Hospital | 5750 E. Baseline Rd., Mesa, AZ 85206 | 2019-04-24 |
1932682184 | Adam Fishel Frose | Psychologist | 4555 E Inverness Ave Ste 112, Mesa, AZ 85206 | 2018-09-13 |
1376024737 | Robyn Kathleen Hall | Psychologist | 4115 East Valley Auto Drive, Suite 208, Mesa, AZ 85206 | 2018-08-23 |
1790264984 | Perspective Health, LLC | Clinic/Center | 1959 S. Power Rd, Suite 103, #206, Mesa, AZ 85206 | 2018-08-09 |
1033605159 | Rebecca Ann Maro | Nurse Practitioner | 6750 E Baywood Ave Ste 502, Mesa, AZ 85206 | 2018-07-02 |
1982195624 | Spark Performance and Physiotherapy | Clinic/Center | 6056 East Basline Road, Suite 147, Mesa, AZ 85206 | 2018-05-29 |
1336645993 | Ashley Wright | Audiologist-Hearing Aid Fitter | 1423 S Higley Rd Ste 119, Mesa, AZ 85206 | 2018-04-03 |
Find all providers in zip 85206 |
Taxonomy Code | 261QR0405X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rehabilitation, Substance Use Disorder |
Definition to come... |
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1154940864 | Light House Group Home LLC | Clinic/Center | 108 E 2nd Ave Ste 101, Mesa, AZ 85210-1410 | 2020-04-13 |
1871128520 | Summit Bhc Mesa LLC | Clinic/Center | 860 N Center St Bldg 1-3, Mesa, AZ 85201-4201 | 2020-03-03 |
1861025876 | Summit Bhc Mesa LLC | Clinic/Center | 846 North Center Street Suite 101, Mesa, AZ 85201 | 2020-02-18 |
1437617958 | Choice Recovery Center, LLC | Clinic/Center | 2222 S Dobson Rd Ste 1002, Mesa, AZ 85202-6200 | 2019-03-04 |
1851740898 | Evolution Way | Clinic/Center | 724 W University Dr, Suite 103, Mesa, AZ 85201-5649 | 2016-06-10 |
1437213725 | Community Bridges | Clinic/Center | 554 S Bellview, Mesa, AZ 85204-2504 | 2006-12-20 |
1518923168 | Curtis Walling, Phd PC | Clinic/Center | 3660 E University Dr, Mesa, AZ 85205-6960 | 2006-04-24 |
1841752581 | Crossroads, Inc. Red Mountain | Clinic/Center | 143 S Center St, Mesa, AZ 85210-1307 | 2019-04-02 |
1598235665 | Phoenix Addiction Recovery LLC | Clinic/Center | 4135 S Power Rd Ste 113, Mesa, AZ 85212-3625 | 2018-11-30 |
1861853756 | Archways Recovery Centers, LLC | Clinic/Center | 2222 S Dobson Rd, Suite 1002, Mesa, AZ 85202-6481 | 2016-03-18 |
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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.