Countryside Capital Estates LLC

Primary specialty

Home Health AideTaxonomy code 374U00000X

Legal business name

COUNTRYSIDE CAPITAL ESTATES LLC

Practice address

3540 E Golf Links Rd
Tucson, AZ 85713-5317

Phone

(520) 822-4208

NPI assigned

Oct 5, 2026

Last updated

Oct 5, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

COUNTRYSIDE CAPITAL ESTATES LLCAs reported in NPPES

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

Authorized official

Name

Derick Kambobe

Title

Manager

Phone

(224) 223-3089

Specialties & licenses 2

Addresses

Part of

Countryside Capital Estates LLC

Locations

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

{
    "created_epoch": "1791158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791158400000",
    "number": "1861396707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 N BUESCHING RD APT 427",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600476723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 E GOLF LINKS RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857135317",
            "telephone_number": "520-822-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRYSIDE CAPITAL ESTATES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTRYSIDE CAPITAL ESTATES LLC",
        "enumeration_date": "2026-10-05",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A",
        "authorized_official_last_name": "KAMBOBE",
        "authorized_official_first_name": "DERICK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "224-223-3089"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.