Healthcare Provider Details

I. General information

NPI: 1003775610
Provider Name (Legal Business Name): LIMELIGHT ASSISTED LIVING - PUEBLO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1165 BROCKDELL DR
COLORADO SPRINGS CO
80911-3547
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: 303-205-0073
Mailing address:
  • Phone: 814-722-1559
  • Fax: 303-205-0073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State

VIII. Authorized Official

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