Organization
KIOWA COUNTY
Active
Other names
Prairie Pines Assisted Living Community
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA SUE WEIRICH (ADMINISTRATOR)
(719) 438-2141
Entity
Organization
Contact information
Practice address
101 E LOWELL AVENUE, EADS, CO 81036-0787
(719) 438-2141
(719) 438-2140
Mailing address
BOX 787, 101 E LOWELL AVENUE, EADS, CO 81036-0787
(719) 438-2141
(719) 438-2140
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL0992
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28621786
—
CO
Enumeration date
02/09/2007
Last updated
08/22/2020
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