| NPI | 1114575008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMINE THOMAS Manager 602-824-8352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2019-09-03 |
| Last Update Date | 2019-09-03 |