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Organization

PUEBLO WEST GARDENS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. KRISS PRADO RN (EXECUTIVE DIRECTOR)
(719) 406-5288
Entity
Organization

Contact information

Practice address
960 E SAXONY DR, PUEBLO WEST, CO 81007-1586
(719) 924-8624
(719) 924-8993
Mailing address
960 E SAXONY DR, PUEBLO WEST, CO 81007-1586
(719) 924-8624
(719) 924-8993

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
23Z781
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
22682554
CO
Enumeration date
10/19/2015
Last updated
10/19/2015
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