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Organization

PARENT CARE LIFE INC DBA CRESTVIEW

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RICKY LEE SIMPSON (ADMINISTRATOR)
(719) 473-6339
Entity
Organization

Contact information

Practice address
1410 E BUENA VENTURA ST, COLORADO SPRINGS, CO 80909-2825
(719) 473-6339
(719) 448-9301
Mailing address
1414 N HANCOCK AVE, COLORADO SPRINGS, CO 80903-2655
(719) 473-6339
(719) 448-9301

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
230542
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
90000143158
HCPF PROVIDER ID
CT
Enumeration date
03/20/2017
Last updated
08/30/2022
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