| NPI | 1255090593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERISA ROSE GIDEON Hcbs Manager 480-933-6069 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child |
| Additional Taxonomies | 251G00000X Hospice Care, Community Based |
| 252Y00000X Early Intervention Provider Agency | |
| 253Z00000X In Home Supportive Care | |
| 305R00000X Preferred Provider Organization | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2021-12-27 |