Organization
ANGKOR WAT EAST ASSISTED LIVING I
Active
Other names
Angkor Wat East Assisted Living, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAM LEM HEAN B.A. (OWNER)
(970) 210-0292
Entity
Organization
Contact information
Practice address
3293 LOMBARDY LN, CLIFTON, CO 81520-7717
(970) 210-0292
(970) 434-7036
Mailing address
207 RIVER RIDGE DR, GRAND JUNCTION, CO 81503-3421
(970) 210-0292
(970) 434-7036
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
23U321
CO
Other
Enumeration date
11/12/2010
Last updated
11/12/2010
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