AMANDA'S CARE HOME LLC (NPI# 1811044944) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811044944 |
| Entity Type | Organization |
| Organization Name | AMANDA'S CARE HOME LLC |
| Practice Address |
8647 E Pampa Ave Mesa AZ 85212-1787 |
| Practice Telephone | 4803738437 |
| Practice Fax Number | 4803738438 |
| Mailing Telephone | 4803738437 |
| Mailing Fax Number | 4803738438 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MARIUS A BUTAS (MANAGER ASSISTED LIVING) |
| Authorized Official Telephone | 4803738437 |
| Authorized Official Credential | MANAGER |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
ALH-A108 | AZ | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AHCCCS PROVIDER ID NUMBER | 774267 | 01 |
| Street Address |
8647 E PAMPA AVE |
| City | MESA |
| State | AZ |
| Zip Code | 85212-1787 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922610302 | West Point Optical Group | Optometrist | 10706 E Point Twenty-two Blvd, #107, Mesa, AZ 85212 | 2020-08-18 |
| 1215553565 | Andrew Eugene Pak | Dentist | 10664 East Point Twenty-two Blvd, Mesa, AZ 85212 | 2020-06-23 |
| 1588200265 | Signal Butte Kids Dentistry and Orthodontics, LLP | Dentist | 10664 E. Point Twenty Two Blvd, Mesa, AZ 85212 | 2019-11-18 |
| 1194371526 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 4316 S Signal Butte Rd, Mesa, AZ 85212 | 2019-08-12 |
| 1194200980 | Highbury Dental Management, LLC | Dentist | 4425 S Mountain Rd, Suite 109, Mesa, AZ 85212 | 2018-09-27 |
| 1033623541 | Latanya Olivia Edenburgs | Case Manager/Care Coordinator | 10436 E Radiant Ave., Mesa, AZ 85212 | 2017-11-20 |
| 1205355880 | Linda Okafor | Nurse Practitioner | 4719 S Calderon Circle, Mesa, AZ 85212 | 2017-09-14 |
| 1689121188 | Agh Mesa LLC | General Acute Care Hospital | 9130 East Elliot Road, Mesa, AZ 85212 | 2016-09-01 |
| 1861841918 | Ryan Blake | Dentist | 4425 S. Mountain Road, Ste 109, Mesa, AZ 85212 | 2016-06-09 |
| 1083089460 | White Glove Health | Nurse Practitioner | 2906 S Lynch Cr, Mesa, AZ 85212 | 2015-12-10 |
| Find all providers in zip 85212 | ||||
| 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.