| NPI | 1003214370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN WATERS Owner 928-595-2068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: AZ AL4632H) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: AZ AL9273H) |
| 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: AZ AL9118H) | |
| 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: AZ AL9592H) | |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2014-12-18 |