OrganizationActive
Cap X-Montecito
NPI 1609600105 · Custodial Care Facility · Peoria, AZ
Provider details
- NPI number
- 1609600105
- Entity type
- Organization
- Primary specialty
- Custodial Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Deatra Johnson, Executive Director(623) 972-1400
Specialties & taxonomies
Nursing & Custodial Care Facilities
- Assisted Living Facility310400000X
Nursing & Custodial Care Facilities
Practice location
17271 N 87th Ave
Peoria, AZ 85382-2777
Phone: (623) 972-1400
Fax: (623) 972-7470
Approximate (ZIP-level) locationGet directions
Mailing address
17271 N 87th Ave
Peoria, AZ 85382-2777
Registry dates
- Enumerated
- 2024-08-27
- Last updated
- 2024-08-27
- Certified
- 2024-08-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.