| NPI | 1720662653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENER BERNARDO Co Owner 602-410-2569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| Enumeration Date | 2021-05-06 |
| Last Update Date | 2021-05-08 |