| NPI | 1134676166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA DARLENE EMBREE Administrator 1480-267-6914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: AZ BH4977) |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2016-09-07 |