| NPI | 1104353770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE LEWIS RAMIREZ Managing Member 520-278-8825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: AZ AP4757) |
| 314000000X Skilled Nursing Facility (Licence: AZ AP4757) | |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2017-11-29 |