| 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 |