Organization
ANGKOR WAT ALTERNATIVE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAM LEM HEAN BA (OWNER)
(970) 210-0292
Entity
Organization
Contact information
Practice address
476 GUNNISON WAY, GRAND JUNCTION, CO 81504-5849
(970) 210-0292
(970) 523-8066
Mailing address
476 GUNNISON WAY, GRAND JUNCTION, CO 81504-5849
(970) 210-0292
(970) 523-8066
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
03/28/2007
Last updated
01/22/2016
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