D&G Providence Care LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

D&G PROVIDENCE CARE LLC

Practice address

9186 W John Cabot Rd
Peoria, AZ 85382-7716

Phone

(480) 285-5907

NPI assigned

Nov 10, 2022

Organization subpart

No

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

Authorized official

Name

Douglas Gasore Kabunda

Title

Manager

Phone

(480) 285-5907

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1598473290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9186 W JOHN CABOT RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853827716",
            "telephone_number": "480-285-5907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9186 W JOHN CABOT RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853827716",
            "telephone_number": "480-285-5907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D&G PROVIDENCE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-10",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "GASORE KABUNDA",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-285-5907"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia D. Gollihar
• Sophia Cyrus, PA-C
• Lisa D'Alessandro-Betancourt, N.P.
• Stephanie Nicole D'Andrea-Escalante
• Sean Benedict D'Souza, MD
• D&L Adult Care Home, LLC
• Joan Dahmer, M.D.
• Vicki Lou Daigle, RN
• Jennifer K. Dais, M.D.
• Sharilyn M Dalton, PA

• Community/Behavioral Health Agency in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.