Customcare CBC, LLC

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

Legal business name

CUSTOMCARE CBC, LLC

Doing business as

Amivie
CustomCARE

Practice address

7801 E Bush Lake Rd Ste 100
Minneapolis, MN 55439-3111

Phone

(952) 914-0269

Fax

(952) 960-0239

NPI assigned

Nov 1, 2006

Organization subpart

No

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 3

Addresses

Other identifiers 3

Other names 2

• Amivie Doing business as
• CustomCARE Doing business as

Locations

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788825600000",
    "number": "1922185677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7801 E BUSH LAKE RD STE 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554393111",
            "telephone_number": "952-914-0269",
            "fax_number": "952-960-0239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7801 E BUSH LAKE RD STE 100",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554393111",
            "telephone_number": "952-914-0269",
            "fax_number": "952-960-0239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1540 Humboldt Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "West St Paul",
            "state": "MN",
            "postal_code": "551183489",
            "country_code": "US",
            "telephone_number": "651-352-9910",
            "fax_number": "651-305-1150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2233 University Ave W Ste 225",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551141696",
            "country_code": "US",
            "telephone_number": "651-377-1122",
            "fax_number": "651-478-1913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CUSTOMCARE CBC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "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": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081603500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDH- TEMPORARY COMPREHENSIVE HOME CARE LICENSE",
            "identifier": "416174",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807970600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amivie",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CustomCARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laurel A Cushing, M.D.
• Camille Carla Cushnie, LGSW
• Rahma Axmed Cusman
• Custom Care Orthotics, Inc
• Customcare CBC, LLC
• Cole Cuthbert, MD, MTM
• Chad A Cutshall, M.D.
• Diana B Cutts, MD
• Erin Cutts, PA-C
• Joseph Mordecai Becker Cutts, MD

• Custodial Care Facility in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Custodial Care Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.