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Organization

VILLA GROVE ASSISTED LIVING HOME

Active
Other names
JOHNSON ASSISTED LIVING HOME, INC.
Organization subpart
No

Provider details

NPI number
Authorized official
PAUL SPICOLA (VICE-PRESIDENT)
(719) 369-4567
Entity
Organization

Contact information

Practice address
715 E B ST, PUEBLO, CO 81003-3504
(719) 544-1561
(719) 542-6539
Mailing address
715 E B ST, PUEBLO, CO 81003-3504
(719) 544-1561
(719) 542-6539

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
23W276
CO

Other

Enumeration date
01/21/2016
Last updated
01/21/2016
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