| NPI | 1134491210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALARIE C. LOMAN Physician 480-718-5986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: AZ 005286) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2012-02-03 |