Organization
HIGH DESERT ASSISTED LIVING, LLC
Active
Other names
Angkor Wat Assisted Living-House 1
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY LYNN IRVIN (OWNER/ADMINISTRATOR)
(970) 640-7371
Entity
Organization
Contact information
Practice address
3293 LOMBARDY LN, CLIFTON, CO 81520-7717
(970) 434-7036
(970) 523-1082
Mailing address
3293 LOMBARDY LN, CLIFTON, CO 81520-7717
(970) 434-7036
(970) 523-1082
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
CO
Other
Enumeration date
12/07/2015
Last updated
12/07/2015
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