| NPI | 1861793457 | 
|---|---|
| Doing Business As | ANGKOR WAT EAST ASSISTED LIVING, INC | 
| 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 23U321) | 
| Enumeration Date | 2010-11-12 | 
| Last Update Date | 2010-11-12 |