| NPI | 1922330158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENNETT T COUSLAND Cota 720-435-4044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: CO 1043282) |
| Enumeration Date | 2010-02-14 |
| Last Update Date | 2010-02-14 |