Cerbat Guest Home Inc.

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

ALC-2600 Issued in AZ

Legal business name

CERBAT GUEST HOME INC.

Practice address

2364 E Carver Ave
Kingman, AZ 86409-1224

Phone

(928) 757-3989

NPI assigned

Dec 27, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Sandra Darlene Schmitz

Title

Secretary,Owner,Manager

Phone

(928) 753-3731

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shanon T Gibbs

  • Assisted Living Facility
  • Kingman, AZ
  • NPI 1518721281
  NPD (past)

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982769907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2364 E CARVER AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864091224",
            "telephone_number": "928-757-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2364 E CARVER AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864091224",
            "telephone_number": "928-757-3989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CERBAT GUEST HOME INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHMITZ",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "DARLENE",
        "authorized_official_title_or_position": "SECRETARY,OWNER,MANAGER",
        "authorized_official_telephone_number": "928-753-3731",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "AZ",
            "license": "ALC-2600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY LICENCE",
            "identifier": "ALC-2600",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryan K Carlson, DMD
• Carman & Co., P.C.
• Mark C Carter, M.D.
• Catholic Charities Community Services
• Central Mohave Medical Clinics LTD
• Annie Myowin Chang-Burns, M.D.
• Charles H. Tadlock, M.D. LTD.
• David Scott Charon, D.M.D.
• Taylor Chase
• Louis Koon Chaw, PHARMD

• All providers in Kingman, AZ
• Adult Care Home Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.