| NPI | 1306356126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM LEE OESTERLE Executive Director 719-510-6659 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2017-10-06 |
| Last Update Date | 2017-10-06 |