| NPI | 1083274591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOROG MAHMOUD Manger 623-703-3860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0630X Assisted Living Facility Assisted Living, Behavioral Disturbances |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2019-06-17 |