| NPI | 1972388999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENNIE LEE HARGROVE CEO 623-249-1119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251B00000X Case Management |
| 251E00000X Home Health | |
| 251G00000X Hospice Care, Community Based | |
| 251S00000X | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| Enumeration Date | 2023-08-28 |
| Last Update Date | 2023-08-28 |