1217 Kenwood LLC
NPI 1982464095ActiveOrganization· Assisted Living Facility· Mesa, AZ
Assisted Living Facility in Mesa, Arizona, registered in NPPES in March 2024, part of 1217 Kenwood LLC. The authorized official on file is Ladonna Edgington, Owner/Operator.
Overview
| NPI | 1982464095 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | 1217 Kenwood LLC |
| NPI issued | Mar 19, 2024 |
| Last updated in NPPES | Sep 20, 2024 |
| Certified by provider | Sep 20, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Assisted Living Facility Primary | 310400000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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