| NPI | 1205848405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN D. BALLIET Administrator 520-795-1610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: AZ NCI2621) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2025-05-15 |