Organization
GOLDEN GATE MANOR INC
Active
Other names
GOLDEN VALLEY
Organization subpart
No
Provider details
NPI number
Authorized official
MARK HARRIMAN (PRESIDENT)
(719) 369-6290
Entity
Organization
Contact information
Practice address
1033 E EVANS AVE, PUEBLO, CO 81004-2538
(719) 369-6290
Mailing address
1337 W ABRIENDO AVE, PUEBLO, CO 81004-1005
(719) 369-6290
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
230667
CO
385H00000X
Respite Care
230667
CO
Other
Enumeration date
11/30/2017
Last updated
11/30/2017
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