| NPI | 1124165469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NINA FAE NETTLES Administrator 602-867-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: AZ BH2458) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2008-06-16 |