| NPI | 1114342169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE C PAUL Manager 623-584-0760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: AZ 0711) |
| Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric (Licence: AZ 0711) |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances (Licence: AZ 0711) | |
| 311500000X Alzheimer Center (Dementia Center) (Licence: AZ 0711) | |
| 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: AZ 0711) | |
| 313M00000X Nursing Facility/Intermediate Care Facility (Licence: AZ 0711) | |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2016-11-08 |