IndividualActive
Crystal Bautista
NPI 1235923954 · Assisted Living Facility (Behavioral Disturbances) · Queen Creek, AZ
Provider details
- NPI number
- 1235923954
- Entity type
- Individual
- Primary specialty
- Assisted Living Facility (Behavioral Disturbances)Nursing & Custodial Care Facilities
- Sex
- Female
- Sole proprietor
- Yes
- License
- 13096H (AZ)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
21002 E Lark Dr
Queen Creek, AZ 85142-1627
Phone: (480) 338-3218
Approximate (ZIP-level) locationGet directions
Mailing address
21002 E Lark Dr
Queen Creek, AZ 85142-1627
Registry dates
- Enumerated
- 2025-04-07
- Last updated
- 2025-04-07
- Certified
- 2025-04-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.