| 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 |