| NPI | 1598120826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM LEM HEAN Owner 970-210-0292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: CO 2311AO) |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2015-12-31 |