Provider Demographics
NPI:1558954552
Name:MIRABELLA AT ASU, INC
Entity type:Organization
Organization Name:MIRABELLA AT ASU, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:SABATINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-221-1425
Mailing Address - Street 1:1 W MAIN ST STE 303
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-2796
Mailing Address - Country:US
Mailing Address - Phone:888-724-6424
Mailing Address - Fax:
Practice Address - Street 1:65 E UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-1091
Practice Address - Country:US
Practice Address - Phone:602-777-7701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-19
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility