# HEARTHSTONE HOSPITAL - MESA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Trillium Specialty Hospital - East Valley
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164677704
- **Authorized official:** MR. GLENN DE SOUZA (PRESIDENT)
- **Authorized official phone:** (480) 945-7711

## Contact information

- **Practice address:** 215 S POWER RD, MESA, AZ 85206-5235
- **Practice address phone:** (480) 985-6992
- **Practice address fax:** (480) 981-8390
- **Mailing address:** 4440 N CIVIC CENTER PLZ, SCOTTSDALE, AZ 85251-3513
- **Mailing address phone:** (480) 945-7711
- **Mailing address fax:** (480) 945-8266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282E00000X | Long Term Care Hospital | SH4388 | AZ | Yes |

## Other

- **Enumeration date:** 11/24/2008
- **Last updated:** 11/24/2008