| NPI | 1508856089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMMY CLEVENGER Controller 602-995-2611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: AZ NCI-256) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: AZ ALC-4281) |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2008-11-04 |