OrganizationActive
412 Home LLC
NPI 1245016344 · Assisted Living Facility · Mesa, AZ
Provider details
- NPI number
- 1245016344
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Authorized official
- Chaim Zimmerman, Manager
Practice location
412 S 30th St
Mesa, AZ 85204-3111
Phone: (480) 584-5666
Fax: (480) 588-5460
Mailing address
412 S 30th St
Mesa, AZ 85204-3111
Registry dates
- Enumerated
- 2023-09-05
- Last updated
- 2023-09-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.