| NPI | 1770753543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE CLAW Administrator 928-674-5216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: AZ 35242) |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2008-04-20 |