| NPI | 1508543505 |
|---|---|
| Doing Business As | ADULT DEVELOPMENTAL HOME |
| Entity Type | Organization |
| Authorized Contact | CANDACE LYNNE BLACKBURN Owner 480-340-3472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-06-30 |
| Last Update Date | 2023-06-30 |