Provider Demographics
NPI:1134808223
Name:CURTIS, BECKY
Entity type:Individual
Prefix:
First Name:BECKY
Middle Name:
Last Name:CURTIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15358 W POST CIR
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-1422
Mailing Address - Country:US
Mailing Address - Phone:623-349-7510
Mailing Address - Fax:623-242-1034
Practice Address - Street 1:15358 W POST CIR
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-1422
Practice Address - Country:US
Practice Address - Phone:623-349-7510
Practice Address - Fax:623-242-1034
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL12511H310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility