NPI | 1508309196 |
---|---|
Doing Business As | LIFESTREAM AT NORTHEAST PHOENIX GREEN HOUSE 85 |
Entity Type | Organization |
Authorized Contact | DONNA TAYLOR Executive Vice President/COO 623-933-3333 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility |
Enumeration Date | 2016-11-30 |
Last Update Date | 2016-11-30 |