Provider Demographics
NPI:1649602459
Name:BARBU, CONSTANTIN
Entity type:Individual
Prefix:
First Name:CONSTANTIN
Middle Name:
Last Name:BARBU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:GREENWAY ADULT
Other - Middle Name:
Other - Last Name:CARE HOME
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5447 E BECK LN
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-1727
Mailing Address - Country:US
Mailing Address - Phone:602-867-3965
Mailing Address - Fax:602-867-3965
Practice Address - Street 1:5447 E BECK LN
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-1727
Practice Address - Country:US
Practice Address - Phone:949-292-1943
Practice Address - Fax:602-867-3965
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL6193H310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ181226OtherAHCCCS