| NPI | 1699772533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY STEPHEN SHINN Administrator 719-473-1105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: CO 0427) |
| Additional Taxonomies | 311500000X Alzheimer Center (Dementia Center) (Licence: CO 0427) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2020-08-22 |