Organization
1111 BONFORTE OPCO, LLC
Active
Other names
Villa Pueblo Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN KIKLIS (CFO)
(303) 952-9216
Entity
Organization
Contact information
Practice address
855 HUNTER DR, PUEBLO, CO 81001-1867
(719) 545-5911
(719) 253-3709
Mailing address
2668 NORTHPARK DR, SUITE 220, LAFAYETTE, CO 80026-3199
(303) 952-9216
(303) 675-5659
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
09/09/2013
Last updated
09/26/2013
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