| NPI | 1346622867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMELYN BESEM Owner/Administrator 480-276-1466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Additional Taxonomies | 315P00000X Intermediate Care Facility, Mentally Retarded |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2015-06-20 |
| Last Update Date | 2015-06-20 |