CACTUS WREN COMMUNITY SERVICES LLC


Address: 3829 W Pollack St, Phoenix, AZ 85041-6118
Phone: 7756860551

CACTUS WREN COMMUNITY SERVICES LLC (NPI# 1457976813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1457976813
Entity Type Organization
Organization Name CACTUS WREN COMMUNITY SERVICES LLC
Practice Address 3829 W Pollack St
Phoenix
AZ 85041-6118
Practice Telephone 7756860551
Enumeration Date 2020-06-11
Last Update Date 2020-06-11
Authorized Official Name MARCUS MCALISTER (OWNER)
Authorized Official Telephone 7756860551
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities Residential Treatment Facilities

Office Location

Street Address 3829 W POLLACK ST
City PHOENIX
State AZ
Zip Code 85041-6118

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Taxonomy Information

Taxonomy Code 320600000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently.
Notes: [7/1/2003: new]

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NPI Name Taxonomy Address Enumeration
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City PHOENIX
Zip Code 85041

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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