Organization Active NPI

Prime Care Residential and Behavioral Services

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1801744065
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
PRIME CARE RESIDENTIAL AND BEHAVIORAL SERVICES
Practice address
6565 N 17TH Ave Apt 11
Phoenix, AZ 85015-1330
Phone
(801) 815-3521
NPI assigned
Mar 21, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Authorized official

Name
Matilda Namuchana Masumba
Title
Authorized Official
Phone
(801) 815-3521

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

6565 N 17TH Ave Apt 11
Phoenix, AZ 85015-1330

Mailing address

6565 N 17TH Ave Apt 11
Phoenix, AZ 85015-1330
Phone (801) 815-3521

National Provider Directory

National Provider Directory
Tax ID family
Prime Care Residential and Behavioral Services2 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.

NPI Registry JSON

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

{
    "created_epoch": "1774051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788393600000",
    "number": "1801744065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 N 17TH AVE APT 11",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850151330",
            "telephone_number": "801-815-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 N 17TH AVE APT 11",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850151330",
            "telephone_number": "801-815-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME CARE RESIDENTIAL AND BEHAVIORAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-21",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A",
        "authorized_official_last_name": "MASUMBA",
        "authorized_official_first_name": "MATILDA",
        "authorized_official_middle_name": "NAMUCHANA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "801-815-3521"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; 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.