CVCC, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NCI-2632 Issued in AZ

Legal business name

CVCC, LLC

Doing business as

Chula Vista Care Center

Practice address

60 S 58TH St
Mesa, AZ 85206-1507

Phone

(480) 832-3903

Fax

(480) 981-0963

NPI assigned

Jul 15, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Deborah D Harwood

Title

Administrator

Phone

(480) 832-3903

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Chula Vista Care Center Doing business as

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245888000000",
    "number": "1083613608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 S 58TH ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061507",
            "telephone_number": "480-832-3903",
            "fax_number": "480-981-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 S 58TH ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061507",
            "telephone_number": "480-832-3903",
            "fax_number": "480-981-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CVCC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-15",
        "last_updated": "2009-06-25",
        "status": "A",
        "authorized_official_last_name": "HARWOOD",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "480-832-3903",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AZ",
            "license": "NCI-2632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "795148",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE CHOICE",
            "identifier": "71-00102",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "AZ0402490",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chula Vista Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Custom Pharmacy LLC (custom rx)
• Custom Smile LLC
• Casey D Cutler, DDS
• Douglas Cutler Scott Cutler, M.A., CCC-SLP
• Marco Antonio Cuyar, MS, LPC, LISAC, NCC
• CVS
• CVS Pharmacy
• CVS Pharmacy
• CVS Pharmacy
• CVS/Pharmacy

• Skilled Nursing Facility in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Skilled Nursing Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; 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.