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Organization

PRAIRIE PINES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LINDA S WATTS (ADMINISTRATOR)
(719) 438-2141
Entity
Organization

Contact information

Practice address
101 E LOWELL AVE, EADS, CO 81036
(719) 438-2141
(719) 438-2140
Mailing address
PO BOX 787, 101 E LOWELL AVE, EADS, CO 81036-0787
(719) 438-2141
(719) 438-2140

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
09781285
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09781285
CO
Enumeration date
06/27/2013
Last updated
06/27/2013
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