Organization
HEARTHSTONE HOSPITAL - MESA, LLC
Active
Other names
Trillium Specialty Hospital - East Valley
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLENN DE SOUZA (CEO)
(480) 945-7711
Entity
Organization
Contact information
Practice address
215 S POWER RD, MESA, AZ 85206-5235
(480) 945-7711
(480) 945-8266
Mailing address
4440 N CIVIC CENTER PLZ, SCOTTSDALE, AZ 85251-3513
(480) 945-7711
(480) 945-8266
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
SH 4388
AZ
282N00000X
General Acute Care Hospital
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
035129
MEDICARE
AZ
05
—
363701
—
AZ
Enumeration date
02/27/2007
Last updated
06/29/2010
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