| NPI | 1770125403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIOSCORO ANGELO TAGLE Owner/Manager 480-208-5137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2019-10-15 |