| NPI | 1790904092 |
|---|---|
| Doing Business As | CRESTVIEW |
| Entity Type | Organization |
| Authorized Contact | RICKY LEE SIMPSON Owner 719-473-6339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: CO AL-0310) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: CO AL-0311) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |