| NPI | 1063519155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH MARY FORD Administrator 520-628-8251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: AZ BH2111) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |