NPI
Prime Care Residential and Behavioral Services
NPI 1780523175
Read from the NPPES registry on October 23, 2026.
Facts
- Status
- Active
- Type
- Organization
- Enumeration date
- 2026-03-28
- Last updated
- 2026-04-29
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Specialties
- 320600000XResidential Treatment Facility, Intellectual and/or Developmental Disabilities · Primary
- 385H00000XRespite Care
- 385HR2065XRespite Care, Respite Care, Physical Disabilities, Child
- 385HR2060XRespite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child
- 253Z00000XIn Home Supportive Care
- 253J00000XFoster Care Agency
- 322D00000XResidential Treatment Facility, Emotionally Disturbed Children
- 320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- 251C00000XDay Training, Developmentally Disabled Services
Licenses
The registry row did not include a license.
Location
- Practice location
- 6565 N 17th Ave Apt 11
- City
- Phoenix AZ
- Postal code
- 85015-1330
- Phone
- (801) 815-3521
Organization contact
- Name
- Matilda Masumba
- Title
- Director
- Phone
- (801) 815-3521
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. Confirm on OIG's online search.
Nearby
Other NPIs in Phoenix, AZ. 44,026 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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