# CVCC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Chula Vista Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083613608
- **Authorized official:** MRS. DEBORAH D HARWOOD (ADMINISTRATOR)
- **Authorized official phone:** (480) 832-3903

## Contact information

- **Practice address:** 60 S 58TH ST, MESA, AZ 85206-1507
- **Practice address phone:** (480) 832-3903
- **Practice address fax:** (480) 981-0963
- **Mailing address:** 60 S 58TH ST, MESA, AZ 85206-1507
- **Mailing address phone:** (480) 832-3903
- **Mailing address fax:** (480) 981-0963

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NCI-2632 | AZ | Yes |

## Other

- **Enumeration date:** 07/15/2005
- **Last updated:** 06/25/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 71-00102 | EVERCARE CHOICE | AZ |
| 05 | — | 795148 | — | AZ |
| 01 | — | AZ0402490 | BLUE CROSS/BLUE SHIELD | AZ |