Country Care Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ALH4144 Issued in AZ

Legal business name

COUNTRY CARE INC

Practice address

3980 E Cassie Lane
Cottonwood, AZ 86326

Phone

(928) 649-0434

Fax

(928) 649-0238

NPI assigned

Sep 12, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Michael Thomas Harris

Title

President

Phone

(928) 274-0702

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1003001033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5302 N 43RD PLACE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850181672",
            "telephone_number": "928-274-0702",
            "fax_number": "602-808-9186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 E CASSIE LANE",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "86326",
            "telephone_number": "928-649-0434",
            "fax_number": "928-649-0238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-274-0702",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "ALH4144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Cottonwood, AZ
• Providers in Cottonwood, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.