CTB AZ, LLC - NPI 1770195612 - Custodial Care Facility in Tempe, AZ

Q: What is Ctb Az, LLC's NPI number?

The NPI number for Ctb Az, LLC is 1770195612. It was assigned to this organization in the NPPES registry on August 21, 2020.

Q: What is Ctb Az, LLC's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

Q: When was this NPI record last updated?

The NPPES record for Ctb Az, LLC was last updated on August 21, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Ctb Az, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CTB AZ, LLC (NPI 1770195612) is a healthcare organization registered as an adult care home in Tempe, Arizona and active in the NPI registry since August 2020. The organization lists Kelly Masengale, Owner, as its authorized official.

NPPES Registry Identity

NPI1770195612

Entity TypeOrganization

Primary Taxonomy311ZA0620X

Legal Business NameCTB AZ, LLC

Location Address2075 S COTTONWOOD DRTempe, AZ 85282-3040

Mailing Address2401 W Southern Ave Lot 462Tempe, AZ 85282-4342 · (602) 318-2041

Phone(602) 318-2041

Organization SubpartNo

Authorized OfficialKelly MasengaleOwner · (602) 318-2041

Enumeration DateAugust 21, 2020

NPPES CertifiedAugust 21, 2020

✔ NPI 1770195612 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 8

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities

Taxonomy Code311ZA0620X

Definition

A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

Also ListedPhysical TherapistTaxonomy 225100000X

Also ListedOccupational TherapistTaxonomy 225X00000X

Also ListedSpeech-Language PathologistTaxonomy 235Z00000X

Also ListedDay Training, Developmentally Disabled ServicesTaxonomy 251C00000X

Also ListedResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesTaxonomy 320600000X

Also ListedDay Training/Habilitation SpecialistTaxonomy 373H00000X

Also ListedRespite Care · Respite Care, Intellectual and/or Developmental DisabilitiesTaxonomy 385HR2060X

2075 S COTTONWOOD DR, Tempe, AZ 85282

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP