# OUR FAMILY CARE HOME ASSISTED LIVING LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356876700
- **Authorized official:** MELISSA ANN MOYLAN (OWNER)
- **Authorized official phone:** (303) 960-8300

## Contact information

- **Practice address:** 1169 JOHNSON STREET, LAKEWOOD, CO 80215
- **Practice address phone:** (541) 598-5336
- **Practice address fax:** (303) 237-1690
- **Mailing address:** 1169 JOHNSON STREET, LAKEWOOD, CO 80215
- **Mailing address phone:** (541) 598-5336
- **Mailing address fax:** (303) 237-1690

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 04/24/2017
- **Last updated:** 04/24/2017