NPIMap

Organization Active NPI

Customcare CBC, LLC

Doing business as Amivie

  • In Home Supportive Care Agency
  • Saint Paul, MN
National Provider Identifier
1740076215
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
CUSTOMCARE CBC, LLC
Doing business as
Amivie
Practice address
2233 University Ave W
Suite 225
St. Paul, MN 55114-1696
Phone
(651) 377-1122
Fax
(888) 688-3674
NPI assigned
Apr 19, 2025
Last updated
Oct 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Authorized official

Name
Kenneth Duarte
Title
Cfo
Phone
(336) 553-5912

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X NU Primary

Addresses

Primary practice location

2233 University Ave W
Suite 225
St. Paul, MN 55114-1696

Mailing address

4000 Paramount Pkwy Ste 100
Morrisville, NC 27560-4702
Phone (919) 390-2980

Other practice location 1

7801 E Bush Lake Rd Ste 100
Minneapolis, MN 55439-3111
Phone (952) 914-0269

Other practice location 2

1540 Humboldt Ave Ste 100
West Saint Paul, MN 55118-3417
Phone (651) 352-9910

Other names 1

  • Amivie Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Amivie2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2233 University Ave W
Ste 225
Saint Paul, MN 55114
Phone (651) 377-1122

1540 Humboldt Ave
Ste 100
West Saint Paul, MN 55118
Phone (651) 352-9910

NPI Registry JSON

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

{
    "created_epoch": "1745020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761177600000",
    "number": "1740076215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 PARAMOUNT PKWY STE 100",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275604702",
            "telephone_number": "919-390-2980",
            "fax_number": "919-390-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 UNIVERSITY AVE W",
            "address_2": "SUITE 225",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "551141696",
            "telephone_number": "651-377-1122",
            "fax_number": "888-688-3674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7801 E Bush Lake Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554393111",
            "country_code": "US",
            "telephone_number": "952-914-0269",
            "fax_number": "952-960-0239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1540 Humboldt Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "West Saint Paul",
            "state": "MN",
            "postal_code": "551183417",
            "country_code": "US",
            "telephone_number": "651-352-9910",
            "fax_number": "651-305-1150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CUSTOMCARE CBC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-19",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A",
        "authorized_official_last_name": "DUARTE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "336-553-5912"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amivie",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; 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.