COUNTRY CARE INC NPI 1003001033

Assisted Living Facility in Cottonwood, AZ

About COUNTRY CARE INC

Country Care Inc is a provider in Cottonwood, AZ. The NPI number assigned to this provider is 1003001033. The practitioner's primary taxonomy code is Assisted Living Facility (310400000X). The provider is registered as an organization and their NPI record was last updated 11 years ago.

NPI	1003001033 National Provider Indentifier (NPI) The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Name	COUNTRY CARE INC
Provider Location Address	3980 E CASSIE LANE COTTONWOOD, AZ 86326 Provider location address The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address	5302 N 43RD PLACE PHOENIX, AZ 85018 Provider mailing address The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity Type	Organization Entity type code The code describing the type of health care provider that is being assigned an NPI. Codes are: 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?	N/A
Is Organization Subpart?	No What is a subpart? Subparts are the components and separate physical locations of organization health care providers. Examples include: Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date	09-12-2007 Provider enumeration date The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date	09-12-2007 Last update date The date that a record was last updated or changed.

Primary Taxonomy

Taxonomy Code	310400000X Primary Taxonomy Code The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Classification	Assisted Living Facility
Type	Nursing & Custodial Care Facilities
License No.	ALH4144
License State	AZ
Taxonomy Description	A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Business Address

COUNTRY CARE INC
3980 E CASSIE LANE
COTTONWOOD, AZ
ZIP 86326
Phone: (928) 649-0434
Fax: (928) 649-0238

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Mailing Address

COUNTRY CARE INC
5302 N 43RD PLACE
PHOENIX, AZ
ZIP 85018
Phone: (928) 274-0702
Fax: (602) 808-9186

Authorized Official

Authorized Official Name	MR. MICHAEL THOMAS HARRIS Authorized official name The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official Title	PRESIDENT
Authorized Official Phone	(928) 274-0702

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