| NPI | 1316263643 |
|---|---|
| Doing Business As | MERILAC LODGE |
| Entity Type | Organization |
| Authorized Contact | MARY ANNE BOGOSOFF Program Director 520-770-8517 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: AZ BH914) |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2010-04-12 |