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General NPI Number Information
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NPI Number | 1710415302
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Entity Type | Organization
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Legal Business Name | FORWARD LIVING CORPORATION
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Dates
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Enumeration Date | 05/26/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4102 NYALA DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80922-2436
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Country | US
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Telephone | 719-460-7629
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Fax |
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Provider Business Mailing Address
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Address Line | 4102 NYALA DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80922-2436
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Country | US
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Telephone | 719-460-7629
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JENNIFER LAPIOLI
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Credential |
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Telephone | 719-460-7629
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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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 | 385H00000X
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Taxonomy Name | Respite Care
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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 | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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