| NPI | 1710179957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY FRANK MAZZITELLO PT A 928-380-5626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: AZ 7492A) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2007-08-13 |