| NPI | 1609600105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEATRA JOHNSON Executive Director 623-972-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2024-08-27 |
| Last Update Date | 2024-08-27 |