| NPI | 1366099384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRI MASENGALE Owner / Director 602-693-3109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251E00000X Home Health | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 373H00000X Day Training/Habilitation Specialist | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2020-08-21 |