| NPI | 1801261516 |
|---|---|
| Doing Business As | ANGKOR WAT ASSISTED LIVING-HOUSE 1 |
| Entity Type | Organization |
| Authorized Contact | TAMMY LYNN IRVIN Owner/Administrator 970-640-7371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2015-12-07 |