Healthcare Provider Details

I. General information

NPI: 1649154659
Provider Name (Legal Business Name): LIMELIGHT ASSISTED LIVING - WEAVER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 08/04/2025
Certification Date: 08/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2602 E WEAVER AVE
CENTENNIAL CO
80121-2951
US

IV. Provider business mailing address

7193 S WATERLOO WAY
AURORA CO
80016-7642
US

V. Phone/Fax

Practice location:
  • Phone: 814-722-1559
  • Fax:
Mailing address:
  • Phone: 814-722-1559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code310500000X
TaxonomyMental Illness Intermediate Care Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MOTOLANI OWOLABI
Title or Position: OWNER
Credential:
Phone: 814-722-1559