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NINA NETTLES

Assisted Living, Mental Illness

Phoenix, Arizona

Provider NPI: 1124165469

Organization Information:
Organization Name:  NINA NETTLES


Practice Location:
3643 E EMILE ZOLA AVE  PHOENIX, AZ 85032 US
Tel: 602-867-7500  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y3104A0625XNursing & Custodial Care Facilities
Assisted Living Facility
Assisted Living, Mental Illness
AZBH2458

Other Provider Identifiers:

IssuerNumberStateType
873936AZ05
STATE LICENCEBH2458AZ01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTAL ILLNESS JOBS AZ - Page 1