NPI | 1053884452 |
---|---|
Entity Type | Organization |
Authorized Contact | BRANDON D JOHNSON Director 928-243-6623 |
Organization Subpart ? | No |
Primary Taxonomy | 310400000X Assisted Living Facility |
Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
385H00000X Respite Care | |
Enumeration Date | 2019-01-08 |
Last Update Date | 2019-01-08 |