OrganizationActive
Heritage Life Center LLC
NPI 1053615906 · Assisted Living Facility (Mental Illness) · Mesa, AZ
Provider details
- NPI number
- 1053615906
- Entity type
- Organization
- Primary specialty
- Assisted Living Facility (Mental Illness)Nursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Reed Gunnell, Owner(480) 307-8809
- License
- AL7718C (AZ)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Nursing & Custodial Care Facilities
Practice location
1040 S Lebaron
Mesa, AZ 85210-3631
Phone: (480) 307-8809
Fax: (480) 781-0019
Approximate (ZIP-level) locationGet directions
Mailing address
1040 S Lebaron
Mesa, AZ 85210-3631
Other names (DBA / former)
- Doing business as
- Heritage Lane Behavioral Assisted Living
Registry dates
- Enumerated
- 2011-01-07
- Last updated
- 2022-05-05
- Certified
- 2022-05-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.