Provider Demographics
NPI:1336358563
Name:HOUSING AUTHORITY OF THE COUNTY OF GRAND, COLORADO
Entity Type:Organization
Organization Name:HOUSING AUTHORITY OF THE COUNTY OF GRAND, COLORADO
Other - Org Name:CLIFFVIEW ASSISTED LIVING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. DIRECTOR, BUSINESS OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:S
Authorized Official - Last Name:CLASEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-699-2413
Mailing Address - Street 1:PO BOX 399
Mailing Address - Street 2:
Mailing Address - City:KREMMLING
Mailing Address - State:CO
Mailing Address - Zip Code:80459-0399
Mailing Address - Country:US
Mailing Address - Phone:970-887-5800
Mailing Address - Fax:970-724-9446
Practice Address - Street 1:710 EAGLE AVE
Practice Address - Street 2:
Practice Address - City:KREMMLING
Practice Address - State:CO
Practice Address - Zip Code:80459
Practice Address - Country:US
Practice Address - Phone:970-724-3530
Practice Address - Fax:970-724-3813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
310400000X
COAL-0079314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO23080ROtherSTATE LICENSE