| NPI | 1902489271 |
|---|---|
| Doing Business As | GRAND VILLA |
| Entity Type | Organization |
| Authorized Contact | DIANE WILSON Accounting Manager 719-481-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2021-05-04 |