Organization
BOONE GUEST HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONNA KAY MCCLURE (OWNER)
(719) 564-0163
Entity
Organization
Contact information
Practice address
526 MAIN ST, BOONE, CO 81025-5002
(719) 564-0163
(719) 564-0193
Mailing address
PO BOX 182, BOONE, CO 81025-0182
(719) 564-0163
(719) 564-0193
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
02570262
CO
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02570262
—
CO
Enumeration date
03/06/2017
Last updated
11/05/2021
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