ANGKOR WAT ALTERNATIVE CARE (NPI# 1598120826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598120826 |
| Entity Type | Organization |
| Organization Name | ANGKOR WAT ALTERNATIVE CARE |
| Practice Address |
476 Gunnison Way Grand Junction CO 81504-5849 |
| Mailing Address |
207 River Ridge Dr Grand Junction CO 81503-3421 |
| Practice Telephone | 9704348240 |
| Mailing Telephone | 9702100292 |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2015-12-31 |
| Authorized Official Name | MR. SAM LEM HEAN (OWNER) |
| Authorized Official Telephone | 9702100292 |
| Authorized Official Credential | B.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
2311AO | CO | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982723466 | Angkor Wat Alternative Care | Assisted Living Facility | 476 Gunnison Way, Grand Junction, CO 81504-5849 | 2007-03-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Angkor Wat Alternative Care Reinstated October 23, 2015 | 476 Gunnison Way, Grand Junction, CO 81504 |
| Street Address |
476 GUNNISON WAY |
| City | GRAND JUNCTION |
| State | CO |
| Zip Code | 81504-5849 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982723466 | Angkor Wat Alternative Care | Assisted Living Facility | 476 Gunnison Way, Grand Junction, CO 81504-5849 | 2007-03-28 |
| 1821607680 | Aspen Meadows Assisted Living, LLC | Assisted Living Facility | 476 Gunnison Way, Grand Junction, CO 81504-5849 | 2020-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699226936 | Ariel Kristine Rendt Padron | Counselor | 639 Long Peak Ct, Grand Junction, CO 81504 | 2016-10-21 |
| 1902197460 | Bereket Yebiyo | Pharmacist | 2992 F Rd., Grand Junction, CO 81504 | 2011-05-02 |
| 1467636787 | Renae Tabin | Physician Assistant | 569 32 Rd Ste 12, Grand Junction, CO 81504 | 2007-12-21 |
| 1689892069 | Mark Newhouse | Physical Therapist | 2777 Crossroads Blvd, Grand Junction, CO 81504 | 2007-04-23 |
| 1841414570 | Deborah Ann Didonato | Registered Nurse | 510 29 .5 Rd, Grand Junction, CO 81504 | 2007-04-12 |
| 1073634952 | Darilynn Sue Maddux | Technician | 510 29.5, Grand Junction, CO 81504 | 2007-04-02 |
| 1538289749 | Shirley Callaway | Registered Nurse | 510 29. 5 Road, Grand Junction, CO 81504 | 2007-03-30 |
| 1407891328 | Dillon Companies LLC | Durable Medical Equipment & Medical Supplies | 569 32 Rd, Grand Junction, CO 81504 | 2006-06-17 |
| 1275536146 | Mesa County Health Department | Registered Nurse | 510 29 1/2 Road, Grand Junction, CO 81504 | 2005-05-24 |
| 1104275882 | Marillac Clinic, Inc | Clinic/Center | 510 29 1/2 Rd, Grand Junction, CO 81504 | 2016-06-03 |
| Find all providers in zip 81504 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215471370 | Family Care Assisted Living LLC | Assisted Living Facility | 174 Edlun Rd, Grand Junction, CO 81503-2220 | 2016-12-08 |
| 1750587077 | Sam Lem Hean | Assisted Living Facility | 174 Edlum Road, Grand Junction, CO 81503 | 2007-06-24 |
| 1982723466 | Angkor Wat Alternative Care | Assisted Living Facility | 476 Gunnison Way, Grand Junction, CO 81504-5849 | 2007-03-28 |
| 1710026760 | Advantage Home Care | Assisted Living Facility | 972 Walnut Ave, Grand Junction, CO 81501 | 2007-02-06 |
| 1821607680 | Aspen Meadows Assisted Living, LLC | Assisted Living Facility | 476 Gunnison Way, Grand Junction, CO 81504-5849 | 2020-07-28 |
| 1922463843 | Crest Ridge Memory Care | Assisted Living Facility | 972 Walnut Ave, Grand Junction, CO 81501-2952 | 2015-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811522071 | Triangle Cross Ranch | Assisted Living Facility | 36049 Co Rd 51, Galeton, CO 80622 | 2020-03-09 |
| 1528539012 | Kasko LLC | Assisted Living Facility | 7120 S Broadway, Littleton, CO 80122-8006 | 2018-12-10 |
| 1346608072 | Just for Seniors Living Center | Assisted Living Facility | 1180 Brentwood St, Lakewood, CO 80214-4015 | 2016-02-09 |
| 1538527973 | Harvey Park Assisted Living LLC | Assisted Living Facility | 1999 S Raleigh St, Denver, CO 80219-5152 | 2016-01-31 |
| 1447615968 | Johnson Home Assisted Living, Inc. | Assisted Living Facility | 403 W 13th St, Pueblo, CO 81003-2748 | 2015-12-28 |
| 1215300058 | Scs Assisted Living Inc | Assisted Living Facility | 8029 S Marshall St, Littleton, CO 80128-5856 | 2015-11-02 |
| 1861793457 | Angkor Wat East Assisted Living I | Assisted Living Facility | 3293 Lombardy Ln, Clifton, CO 81520-7717 | 2010-11-12 |
| 1043484140 | P.a.l's Acf & Day Program | Assisted Living Facility | 232 Broadway Ave, Pueblo, CO 81004-2102 | 2008-04-18 |
| 1093917098 | C-c Boarding Home | Assisted Living Facility | 412 S Hancock Ave, Colorado Springs, CO 80903-3700 | 2007-06-01 |
| 1972712701 | Princeton House | Assisted Living Facility | 3884 W Princeton Cir, Denver, CO 80236-3111 | 2007-05-21 |
| Find all providers with the same taxonomy | ||||
| City | GRAND JUNCTION |
| Zip Code | 81504 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.