Provider Demographics
NPI:1124346416
Name:CAST YOUR CARES LLC
Entity type:Organization
Organization Name:CAST YOUR CARES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:M
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-268-3220
Mailing Address - Street 1:1146 N MESA DR STE 102-291
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-3586
Mailing Address - Country:US
Mailing Address - Phone:480-268-3220
Mailing Address - Fax:480-655-7812
Practice Address - Street 1:1836 N STAPLEY DR UNIT 3
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85203-2671
Practice Address - Country:US
Practice Address - Phone:480-655-7812
Practice Address - Fax:480-655-7812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-11
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ515866OtherAHCCS