| NPI | 1821618679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMELIA ABELLA TAGALOGUIN Member 480-338-0834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2020-04-22 |