NPI 1770195612
Ctb Az, LLC
Practice location
- Address
- 2075 S Cottonwood Dr, Tempe, AZ 85282-3040
- Phone
- (602) 318-2041
- Mailing address
- 2401 W Southern Ave Lot 462, Tempe, AZ 85282-4342
Authorised official
- Name
- Kelly Masengale
- Title
- Owner
- Phone
- (602) 318-2041
Registered specialties (8)
Adult Care Home Facility
Primary
Physical Therapist
Occupational Therapist
Speech-Language Pathologist
Developmentally Disabled Services Day Training Agency
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Day Training/Habilitation Specialist
Child Intellectual and/or Developmental Disabilities Respite Care
Registry record
- NPI
- 1770195612
- Entity type
- Organization
- NPI issued
- 21 Aug 2020
- Record last updated
- 21 Aug 2020
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.