| NPI | 1114203601 |
|---|---|
| Doing Business As | MAPLEGROVE EAST AT CRESTVIEW |
| Entity Type | Organization |
| Authorized Contact | RICKY LEE SIMPSON Administrator 719-473-6339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: CO 23G509) |
| Additional Taxonomies | 311Z00000X Custodial Care Facility (Licence: CO 23G509) |
| 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: CO 23G509) | |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2011-10-27 |