| NPI | 1164670691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA POP Owner Manager 623-376-8411 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: AZ ALH2495) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: AZ ID539231) |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2008-09-09 |