Organization
GREENWOOD MANOR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN CARTER WELLS (ADMINISTRATOR)
(719) 778-2934
Entity
Organization
Contact information
Practice address
421 W 11TH ST, PUEBLO, CO 81003-2806
(719) 778-2934
(719) 542-6098
Mailing address
421 W 11TH ST, PUEBLO, CO 81003-2806
(719) 778-2934
(719) 542-6098
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
23062L
CO
Other
Enumeration date
05/29/2018
Last updated
05/29/2018
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