| NPI | 1376085597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALARIE GROGAN Physician 480-718-5986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2020-08-12 |