OrganizationActive
412 S 30th St LLC
NPI 1821874934 · Assisted Living Facility · Mesa, AZ
Provider details
- NPI number
- 1821874934
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Chaim Zimmerman, Manager(480) 584-5666
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
412 S 30th St
Mesa, AZ 85204-3111
Phone: (480) 584-5666
Fax: (480) 588-5460
Approximate (ZIP-level) locationGet directions
Mailing address
412 S 30th St
Mesa, AZ 85204-3111
Registry dates
- Enumerated
- 2023-09-05
- Last updated
- 2023-09-05
- Certified
- 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.