Provider Demographics
NPI:1659965291
Name:NESHAMA INC.
Entity Type:Organization
Organization Name:NESHAMA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:JANDL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-295-0056
Mailing Address - Street 1:364 S SMITH RD
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-3092
Mailing Address - Country:US
Mailing Address - Phone:480-729-6537
Mailing Address - Fax:
Practice Address - Street 1:12402 N 102ND ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-5106
Practice Address - Country:US
Practice Address - Phone:651-295-0056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home