Healthcare Provider Details

I. General information

NPI: 1164286688
Provider Name (Legal Business Name): THE LEMONADE HOUSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39402 COLONY UNION ST
MURRIETA CA
92563-7327
US

IV. Provider business mailing address

3312 CORTE DEL CRUCE
CARLSBAD CA
92009-9546
US

V. Phone/Fax

Practice location:
  • Phone: 760-272-6816
  • Fax:
Mailing address:
  • Phone: 760-272-6816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: AMY KONOPKA
Title or Position: MANAGING DIRECTOR
Credential:
Phone: 760-272-6816