Organization
WESTSIDE ASSISTED LIVING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LYNN PAUL BOESE (OWNER)
(719) 578-1355
Entity
Organization
Contact information
Practice address
816 W KIOWA ST, COLORADO SPRINGS, CO 80905-1423
(719) 578-1355
(719) 578-5889
Mailing address
2916 LA ESTRELLA CIR, COLORADO SPRINGS, CO 80917-3313
(719) 591-1629
(719) 574-7917
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04142410
—
CO
Enumeration date
12/19/2006
Last updated
08/22/2020
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