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General NPI Number Information
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NPI Number | 1962872788
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Entity Type | Organization
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Legal Business Name | SANFORD & CLAY CARE INC
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Dates
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Enumeration Date | 10/06/2015
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Last Update Date | 10/06/2015
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Provider Practice Location Address
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Address Line | 233 MAIN ST
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City | DELTA
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State | CO
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Zip | 81416-1814
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Country | US
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Telephone | 970-874-1117
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Fax | 970-874-8853
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Provider Business Mailing Address
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Address Line | 233 MAIN ST
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City | DELTA
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State | CO
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Zip | 81416-1814
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Country | US
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Telephone | 970-874-1117
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Fax | 970-874-8853
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Authorized Official
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Title or Position | MANAGER
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Name | MICHELLE TRUJILLO
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Credential |
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Telephone | 970-874-1117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 231113
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License Number State | CO
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