OrganizationActive
Nina Nettles
NPI 1124165469 · Assisted Living Facility (Mental Illness) · Phoenix, AZ
Provider details
- NPI number
- 1124165469
- Entity type
- Organization
- Primary specialty
- Assisted Living Facility (Mental Illness)Nursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Nina Nettles, Administrator(602) 867-7500
- License
- BH2458 (AZ)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
3643 E Emile Zola Ave
Phoenix, AZ 85032-6219
Phone: (602) 867-7500
Approximate (ZIP-level) locationGet directions
Mailing address
3643 E Emile Zola Ave
Phoenix, AZ 85032-6219
Registry dates
- Enumerated
- 2007-01-30
- Last updated
- 2008-06-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.