Tech Capital Source LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

TECH CAPITAL SOURCE LLC

Doing business as

Blue Haven Homes

Practice address

5977 E 18TH Ave
Apache Junction, AZ 85119-7703

Phone

(480) 800-7027

NPI assigned

Dec 29, 2022

Last updated

Dec 29, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeff Glover

Title

Owner

Phone

(480) 331-1088

Specialties & licenses 1

Addresses

Other names 1

• Blue Haven Homes Doing business as

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

{
    "created_epoch": "1672272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672272000000",
    "number": "1336852870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5977 E 18TH AVE",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851197703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5977 E 18TH AVE",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851197703",
            "telephone_number": "480-800-7027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TECH CAPITAL SOURCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-29",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-28",
        "status": "A",
        "authorized_official_last_name": "GLOVER",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-331-1088"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Haven Homes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Apache Junction, AZ
• Providers in Apache Junction, 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 Dec 29, 2022; 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.