SHADOW MOUNTAIN MANAGEMENT
Nursing at Phay Ave, Canon City, CO

License number
Colorado 0055
Category
Nursing
Type
Skilled Nursing Facility
Owner
Name: MR. WAYNE STOCK NHA
Title: ADMINISTRATOR
Phone: (719) 275-8656
Address
Address
1401 Phay Ave, Canon City, CO 81212
National Provider ID: 1366430910
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Shadow Mountain Management Corporation

1401 Phay Ave, Canon City, CO 81212

Industry:
Skilled Nursing Care Facility
Doing business as:
Pikes Peak Lodge #38
Phone:
(719) 275-8656 (Phone)
Payroll Clerks:
John Havill (President),Roger Keefner (Maintenance Supervisor),Candi Foreaker (Computer Specialist, Maintenance Supervisor),...

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