Organization
CVCC, LLC
Active
Other names
Chula Vista Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBORAH D HARWOOD (ADMINISTRATOR)
(480) 832-3903
Entity
Organization
Contact information
Practice address
60 S 58TH ST, MESA, AZ 85206-1507
(480) 832-3903
(480) 981-0963
Mailing address
60 S 58TH ST, MESA, AZ 85206-1507
(480) 832-3903
(480) 981-0963
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCI-2632
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71-00102
EVERCARE CHOICE
AZ
05
—
795148
—
AZ
01
—
AZ0402490
BLUE CROSS/BLUE SHIELD
AZ
Enumeration date
07/15/2005
Last updated
06/25/2009
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