LIGHTHOUSE RESIDENITAL (NPI# 1710483714) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710483714 |
| Entity Type | Organization |
| Organization Name | LIGHTHOUSE RESIDENITAL |
| Practice Address |
10200 W 44th Ave Ste 400b Wheat Ridge CO 80033-6826 |
| Practice Telephone | 7204650920 |
| Practice Fax Number | 3033370038 |
| Mailing Telephone | 7204650920 |
| Mailing Fax Number | 3033370038 |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2018-03-30 |
| Authorized Official Name | TERESA HORNBUCKLE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7204650920 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
10200 W 44TH AVE STE 400B |
| City | WHEAT RIDGE |
| State | CO |
| Zip Code | 80033-6826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154893915 | Bronwyn Hockersmith | Counselor | 3954 Yosemite St, Wheat Ridge, CO 80033 | 2018-12-18 |
| 1902392004 | Thousand Peaks Healthcare, Inc. | In Home Supportive Care | 4891 Independence St Ste 285, Wheat Ridge, CO 80033 | 2018-07-02 |
| 1528586120 | Front Range Family Resource Center | Marriage & Family Therapist | 5181 Ward St Ste 201, Wheat Ridge, CO 80033 | 2017-09-03 |
| 1962920918 | Dianna Lee Cordero | Counselor | 4931 Garrison St., Apt 104, Wheat Ridge, CO 80033 | 2017-08-30 |
| 1396261525 | Lauren Faye Petasne | Nurse Practitioner | 7100 W 44th Ave Ste 101a, Wheat Ridge, CO 80033 | 2017-08-18 |
| 1558802421 | Elizabeth Ann Huddleston | Nurse Practitioner | 3400 N Lutheran Pkwy, Wheat Ridge, CO 80033 | 2017-03-13 |
| 1053777045 | Richard Kerry Brandow | Counselor | 16625 W 50th Ave., Golden, CO 80033 | 2016-01-07 |
| 1831562131 | Eternal Life Care Centers, LLC | Assisted Living Facility | 4370 Ingalls Street, Wheat Ridge, CO 80033 | 2015-11-09 |
| 1740663483 | Real Care, Inc. | Private Vehicle | 10200 West 44th Ave, Suite 200, Wheat Ridge, CO 80033 | 2015-06-30 |
| 1508254848 | Pamela June Weitzel | Midwife | 3555 Lutheran Parkway Suite 210, Wheat Ridge, CO 80033 | 2015-01-08 |
| Find all providers in zip 80033 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700419488 | Hanna Cares, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6550 S Ider St, Aurora, CO 80016-1251 | 2020-02-20 |
| 1235760521 | A Safe Place In Pagosa, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 459 Lewis Street, Pagosa Springs, CO 81147 | 2020-01-27 |
| 1649836982 | Esther House | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1051 Lima St, Aurora, CO 80010-3701 | 2019-05-13 |
| 1730742297 | Mesa Developmental Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 309 Kava Way, Grand Junction, CO 81503-3153 | 2019-04-19 |
| 1013570571 | Mesa Developmental Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3301 Laurel Ln, Clifton, CO 81520-8123 | 2019-04-19 |
| 1083106744 | Jon W. Baker Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3835 Mckay Rd, Colorado Springs, CO 80906-5707 | 2018-05-30 |
| 1952816795 | Sozo Sss International LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6324 S Sicily Way, Aurora, CO 80016-7009 | 2017-12-01 |
| 1457875999 | Sandra Douglas | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3109 66th Ave, Greeley, CO 80634-8932 | 2017-07-26 |
| 1356876700 | Our Family Care Home Assisted Living LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1169 Johnson Street, Lakewood, CO 80215 | 2017-04-24 |
| 1619408366 | Dd Squared Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1580 S Salida Way, Aurora, CO 80017-4210 | 2017-03-24 |
| Find all providers with the same taxonomy | ||||
| City | WHEAT RIDGE |
| Zip Code | 80033 |
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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.