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Nursing & Custodial Care Facilities Assisted Living Facility

Provider NPI: 1538331251

Organization Information:
Organization is not Subpart
Authorized Official:  DAVE  MCREYNOLDS  OWNER  970-227-9264

Practice Location:
Tel: 970-593-0102  Fax: --

Business Mailing Address:
Tel: --  Fax: --

NPI Information:
NPI: 1538331251
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Y310400000XNursing & Custodial Care Facilities
Assisted Living Facility

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 310400000X





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