Healthcare Provider Details

I. General information

NPI: 1134781057
Provider Name (Legal Business Name): LIGHTHOUSE COMPLEX CARE LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2019
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14095 E EXPOSITION AVE
AURORA CO
80012-2522
US

IV. Provider business mailing address

14095 E EXPOSITION AVE
AURORA CO
80012-2522
US

V. Phone/Fax

Practice location:
  • Phone: 303-219-0030
  • Fax: 303-600-7340
Mailing address:
  • Phone: 303-219-0030
  • Fax: 303-600-7340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: KARA DARLING
Title or Position: OWNER
Credential:
Phone: 303-219-0030