BREANNA HOMES, LLC (NPI# 1366909756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366909756 |
| Entity Type | Organization |
| Organization Name | BREANNA HOMES, LLC |
| Practice Address |
5632 E Fairbrook St Mesa AZ 85205-5571 |
| Practice Telephone | 4805045780 |
| Practice Fax Number | 4804631551 |
| Mailing Telephone | 4803069478 |
| Enumeration Date | 2019-02-21 |
| Last Update Date | 2019-02-21 |
| Authorized Official Name | ROBERTO ARAYON (STATUTORY AGENT) |
| Authorized Official Telephone | 4803069478 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| Street Address |
5632 E FAIRBROOK ST |
| City | MESA |
| State | AZ |
| Zip Code | 85205-5571 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164631487 | Evelyn Stansbarger | Assisted Living Facility | 5632 E Fairbrook St, Mesa, AZ 85205-5571 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083130199 | Rose Campbell | Technician/Technologist | 649 North Orlando, Mesa, AZ 85205 | 2017-08-21 |
| 1528459781 | Elizabeth Sadler | Nurse Practitioner | 4434 E Brown Rd Ste 102, Mesa, AZ 85205 | 2015-02-10 |
| 1326444324 | Katherine G Perez | Counselor | 152 N Power Rd Ste 2, Mesa, AZ 85205 | 2014-11-18 |
| 1831500800 | C.b.o Hearing | Hearing Aid Equipment | 4406 E. Main St, Suite 103, Mesa, AZ 85205 | 2014-05-13 |
| 1699195107 | Amanda Mcdaniel | Occupational Therapist | 5911 E. Fountain St., Mesa, AZ 85205 | 2014-04-23 |
| 1952640278 | Medstar Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 3932 E Fairfield Cir, Mesa, AZ 85205 | 2013-02-06 |
| 1245575398 | Fabulous Smiles of Mesa | Dentist | 4434 E. Brown Rd, Ste 104, Mesa, AZ 85205 | 2012-11-30 |
| 1992087639 | Matthew Robert Millward | Pharmacist | 1935 N. Power Rd, Mesa, AZ 85205 | 2011-09-19 |
| 1740596733 | Arizona Family & Geriatric Medicine Pllc | Clinic/Center | 5602 E. Main St., Mesa, AZ 85205 | 2010-08-27 |
| 1295049609 | Thomas Chambers | Podiatrist | 5520 E Main St Ste 2, Mesa, AZ 85205 | 2010-07-28 |
| Find all providers in zip 85205 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932728581 | Michael Ford | Custodial Care Facility | 10462 E Abilene Ave, Mesa, AZ 85208-8717 | 2020-04-14 |
| 1366977506 | Woodward Foundation for The Disabled | Custodial Care Facility | 33 S Sycamore, Suite 1, Mesa, AZ 85202-1150 | 2017-04-25 |
| 1275071433 | Anderson Assisted Living Homes, LLC | Custodial Care Facility | 9831 E Broadway Rd, Mesa, AZ 85208-2505 | 2017-02-08 |
| 1447525324 | Family Care Homes, Inc. | Custodial Care Facility | 1511 N Gilbert Rd, Mesa, AZ 85203-3902 | 2012-03-12 |
| 1114296332 | Life Sonoran Homnes | Custodial Care Facility | 2036 E Calle Maderas, Mesa, AZ 85213-2910 | 2011-12-16 |
| 1174815302 | Better Living Carehome LLC | Custodial Care Facility | 9321 E Carmel Ave, Mesa, AZ 85208-5834 | 2011-05-05 |
| 1003081860 | M E D Services | Custodial Care Facility | 3759 E Clovis Ave, Mesa, AZ 85206-1841 | 2008-04-23 |
| 1609041458 | M E D Services | Custodial Care Facility | 3065 S Canfield Cir, Mesa, AZ 85212 | 2008-04-23 |
| 1154511202 | Third Street Home | Custodial Care Facility | 1053 E 3rd St, Mesa, AZ 85203-8001 | 2007-07-25 |
| 1730382862 | Lauras Assisted Living | Custodial Care Facility | 1338 W Lobo Ave, Mesa, AZ 85202-6651 | 2007-06-06 |
| 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.