| NPI | 1215471370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM L HEAN Owner 970-210-0292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: CO 23111U) |
| Enumeration Date | 2016-12-08 |
| Last Update Date | 2016-12-08 |