Healthcare Provider Details
I. General information
NPI: 1861841751
Provider Name (Legal Business Name): CAAB HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/10/2016
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1727 E PECOS RD
GILBERT AZ
85295-5057
US
IV. Provider business mailing address
5150 S INSPIRIAN PKWY UNIT 1107
MESA AZ
85212-8870
US
V. Phone/Fax
- Phone: 972-815-7140
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JANET
FOSTER
Title or Position: DIRECTOR
Credential:
Phone: 469-235-0280