Organization
SECOND HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GURGEN KRYLOV (MEMBER)
(720) 448-7406
Entity
Organization
Contact information
Practice address
390 PRINTERS PKWY, COLORADO SPRINGS, CO 80910-3190
(719) 375-8121
Mailing address
390 PRINTERS PKWY, COLORADO SPRINGS, CO 80910-3190
(719) 375-8121
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
01/14/2019
Last updated
02/17/2025
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