| NPI | 1184825697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENID BALLENTINE Manager 928-757-2736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: AZ ALH5972) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2008-06-19 |