NPI Code Details Logo

NPI 1639048564

NPI 1639048564 : FAMILY FAITH ADULT DAYCARE : COLORADO SPRINGS, CO

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1639048564
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    FAMILY FAITH ADULT DAYCARE 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    10/30/2025
-----------------------------------------------------
    Last Update Date     |    12/04/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2055 S MURRAY BLVD 
-----------------------------------------------------
    City                 |    COLORADO SPRINGS
-----------------------------------------------------
    State                |    CO
-----------------------------------------------------
    Zip                  |    80916-4877
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    719-493-4346
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    10905 ROLLING MESA DR 
-----------------------------------------------------
    City                 |    FALCON
-----------------------------------------------------
    State                |    CO
-----------------------------------------------------
    Zip                  |    80831-3842
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    231-620-4208
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    DIRECTOR
-----------------------------------------------------
    Name                 |     OLU  AKANDE 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    231-620-4208
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    171400000X
-----------------------------------------------------
    Taxonomy Name        |    Health & Wellness Coach
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    261QM1300X
-----------------------------------------------------
    Taxonomy Name        |    Multi-Specialty Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    3104A0630X
-----------------------------------------------------
    Taxonomy Name        |    Assisted Living Facility (Behavioral Disturbances)
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
    Taxonomy Code        |    373H00000X
-----------------------------------------------------
    Taxonomy Name        |    Day Training/Habilitation Specialist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
    Taxonomy Code        |    225A00000X
-----------------------------------------------------
    Taxonomy Name        |    Music Therapist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
    Taxonomy Code        |    364SR0400X
-----------------------------------------------------
    Taxonomy Name        |    Rehabilitation Clinical Nurse Specialist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #7
-----------------------------------------------------
    Taxonomy Code        |    311ZA0620X
-----------------------------------------------------
    Taxonomy Name        |    Adult Care Home Facility
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.