COMFORT HAVEN OF MESA – NPI #1629198858
Residential Treatment Facility, Physical Disabilities

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.

COMFORT HAVEN OF MESA is a residential treatment facility (RTF) located in MESA, AZ. NPPES has assigned the NPI number 1629198858 to COMFORT HAVEN OF MESA on March 30, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “COMFORT HAVEN OF MESA” is a dba name, the actual legal business name for this organization is ACTIVE ASSISTED LIVING, LLC. The primary taxonomy selected by this provider is 320700000X from the Health Care Provider Taxonomy code set, which is classified as Residential Treatment Facility, Physical Disabilities.

The NPI profile was previously updated about 19 years ago on Aug 01, 2007. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for COMFORT HAVEN OF MESA below.

NPI Profile for
ACTIVE ASSISTED LIVING, LLC

NPI Number
1629198858
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ACTIVE ASSISTED LIVING, LLC
Doing Business As (dba): COMFORT HAVEN OF MESA
Primary location
758 S TOLTEC
MESA, AZ 85204-3642
Phone: (480) 461-8272 Fax: (480) 461-4682
Mailing address
1235 S GILBERT RD
STE 3, PMB 83
MESA, AZ 85204-6005
Phone: (480) 461-8272 Fax: (480) 461-4682
Organization Subpart
No
Authorized Official
STEVEN THARALSON
DIRECTOR
Phone: (480) 461-8272
Updated
Identifiers

Identifiers for COMFORT HAVEN OF MESA

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERASSISTED LIVING LICENSEAZALH-4567
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320700000X
- Residential Treatment Facility, Physical Disabilities (Primary)
AZ ALH-4567

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.