| NPI | 1952820557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA DIANNE CRAYTON Administrator 623-693-3112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AZ 044613) |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2022-07-21 |