Cactus Sage LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

CACTUS SAGE LLC

Practice address

3424 E Coronado Rd
Phoenix, AZ 85008-3826

Phone

(623) 225-1240

NPI assigned

Jan 5, 2021

Last updated

Jan 5, 2021By 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

Mrs. Geraldine Mutwol

Title

Ceo

Phone

(623) 225-1240

Specialties & licenses 1

Addresses

Tax ID family

Cactus Sage 23 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Cactus Sage LLC

  dba Cactus Sage 3

  • Mental Illness Community Based Residential Treatment Facility
  • Laveen, AZ
  • NPI 1336881911
  NPD tax ID
• Cactus Sage LLC

  dba Cactus Sage 2

  • Mental Illness Community Based Residential Treatment Facility
  • Casa Grande, AZ
  • NPI 1568132959
  NPD tax ID

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609804800000",
    "number": "1902494941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3848 E POLLACK ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850426207",
            "telephone_number": "623-225-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3424 E CORONADO RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850083826",
            "telephone_number": "623-225-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CACTUS SAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-05",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A",
        "authorized_official_last_name": "MUTWOL",
        "authorized_official_first_name": "GERALDINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "623-225-1240",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Illness Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.