| NPI | 1992906408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENID BALLENTINE Manager 928-753-9428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: AZ ALH6156) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2008-08-08 |