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General NPI Number Information
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NPI Number | 1609714898
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Entity Type | Organization
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Legal Business Name | LIMELIGHT ASSISTED LIVING - PUEBLO LLC
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Dates
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Enumeration Date | 03/23/2026
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 431 QUINCY ST
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City | PUEBLO
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State | CO
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Zip | 81004-2027
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Country | US
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Telephone | 814-722-1559
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Fax | 303-205-0073
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Provider Business Mailing Address
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Address Line | 7193 S WATERLOO WAY
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City | AURORA
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State | CO
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Zip | 80016-7642
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Country | US
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Telephone | 814-722-1559
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Fax | 303-205-0073
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Authorized Official
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Title or Position | ADMIN
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Name | MOTOLANI OWOLABI
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Credential |
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Telephone | 814-722-1559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 310500000X
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Taxonomy Name | Mental Illness Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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