MRS. LESLIE POTTEBAUM (NPI# 1134642952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134642952 |
| Entity Type | Individual |
| Full Name | MRS. LESLIE POTTEBAUM |
| Practice Address |
16155 W 74th Dr Arvada CO 80007-7828 |
| Practice Telephone | (303) 912-1111 |
| Mailing Telephone | 3039121111 |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2017-07-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | CO | Residential Treatment Facilities |
| Street Address |
16155 W 74TH DR |
| City | ARVADA |
| State | CO |
| Zip Code | 80007-7828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285949362 | Cy-less Ranch | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 16155 W 74th Dr, Arvada, CO 80007-7828 | 2010-08-12 |
| 1497308670 | Leslie Pottebaum | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 16155 W 74th Dr, Arvada, CO 80007-7828 | 2019-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699280750 | Dillon Companies LLC | Durable Medical Equipment & Medical Supplies | 14967 Candelas Pkwy, Arvada, CO 80007 | 2017-12-11 |
| 1306220603 | Chic/larkin Ventures, LLC | Clinic/Center | 16320 West 64th Avenue, Arvada, CO 80007 | 2015-07-16 |
| 1053574723 | Tarrah Lynn Bobay Cooper | Nurse Anesthetist, Certified Registered | 8640 Zircon Way, Arvada, CO 80007 | 2008-07-03 |
| 1275685547 | Kerry Anne Derrick | Marriage & Family Therapist | 7724 Terry Court, Arvada, CO 80007 | 2007-01-17 |
| 1649206111 | Dillon Companies LLC | Durable Medical Equipment & Medical Supplies | 15200 W 64th Ave, Arvada, CO 80007 | 2006-06-24 |
| 1417446279 | Arvada Dental Excellence PC | Dentist | 15530 W 64th Ave, Unit J, Arvada, CO 80007 | 2018-05-08 |
| 1447267216 | Stanley D Crawford | Dentist | 16205 W 64th Ave, Ste 101, Arvada, CO 80007 | 2006-08-02 |
| 1215215249 | Nishma Shirish Shah | Dentist | 14807 W 64th Ave Unit C, Arvada, CO 80007-0104 | 2011-07-25 |
| 1558521955 | Tjark Ryan Beaven | Dentist | 14807 W 64th Ave, Suite C, Arvada, CO 80007-0104 | 2008-06-10 |
| 1336669753 | Jameson Ribbens | Dentist | 14807 W 64th Ave Unit C, Arvada, CO 80007-0104 | 2017-06-27 |
| Find all providers in zip 80007 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598206013 | Developmental Opportunities | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11491 W 60th Ave, Arvada, CO 80004-4403 | 2017-03-16 |
| 1174066815 | Developmental Disabilities Resource Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7564 W 83rd Ave, Arvada, CO 80003-1609 | 2016-11-29 |
| 1457474553 | Developmental Disabilities Resource Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10949 W 62nd Pl, Arvada, CO 80004-4523 | 2007-04-06 |
| 1497308670 | Leslie Pottebaum | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 16155 W 74th Dr, Arvada, CO 80007-7828 | 2019-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982203535 | Special Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2776 S Dunkirk Ct, Aurora, CO 80013-4744 | 2020-10-23 |
| 1083220750 | Liberty Residential LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 923 S Telluride St, Aurora, CO 80017-3346 | 2020-09-18 |
| 1386254019 | Grace Mountain LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6030 Blue Ridge Dr Apt H, Highlands Ranch, CO 80130-3630 | 2020-08-07 |
| 1598381766 | Hand and Heart Host Homes Agency | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 391 S Simms St, Lakewood, CO 80228-2905 | 2020-06-23 |
| 1750907135 | Bianca Alish Lott | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17827 E Mexico Dr, Aurora, CO 80017-5378 | 2020-06-22 |
| 1790300705 | Haset | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 855 S Kalispell Cir Unit 205, Aurora, CO 80017-2098 | 2020-06-15 |
| 1619599826 | Metro Hearts Host Homes Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1192 Sandpiper Ln, Brighton, CO 80601-7391 | 2020-05-11 |
| 1588283550 | Roots, Limited Liability Co. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 436 Purple Plum Ct, Fruita, CO 81521-6205 | 2020-04-10 |
| 1235760497 | Garden Neighbors, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2773 W Long Dr, Littleton, CO 80120-5531 | 2020-01-27 |
| 1386284461 | Integrated Life Choices | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7800 S Elati St Ste 111, Littleton, CO 80120-4400 | 2020-01-07 |
| Find all providers with the same taxonomy | ||||
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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.