Organization
KHEYRE AND MOALIM CORPORATION
Active
Parent organization
KHEYRA & MOALLIM CORPORATION
Other names
Fountainhead Care Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
KHEYRA & MOALLIM CORPORATION
Authorized official
SAHRA O MOALIM OWNER (MANAGER)
(720) 936-0483
Entity
Organization
Contact information
Practice address
1398 ZEPHYR ST, LAKEWOOD, CO 80214-4269
(720) 936-0483
Mailing address
1398 ZEPHYR ST, LAKEWOOD, CO 80214-4269
(720) 936-0483
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
2304C3
CO
Other
Enumeration date
08/03/2016
Last updated
08/03/2016
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