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NPI Code Detail

MEDICARE: LIMELIGHT ASSISTED LIVING - PUEBLO LLC

MEDICARE: LIMELIGHT ASSISTED LIVING - PUEBLO LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13104A0625XAssisted Living Facility (Mental Illness)
23104A0630XAssisted Living Facility (Behavioral Disturbances)
3310500000XMental Illness Intermediate Care Facility
4310400000XAssisted Living Facility

General Provider Information

NPI Number : 1851239032
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIMELIGHT ASSISTED LIVING - PUEBLO LLC
Provider Business Mailing Address
First Line : 7193 S WATERLOO WAY
Second Line :
City : AURORA
State : CO
Zip : 80016-7642
Country : US
Telephone Number : 814-722-1559
Fax Number : 303-205-0073
Provider Business Practice Location Address
First Line : 1420 E FOUNTAIN BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80910-3502
Country : US
Telephone Number : 814-722-1559
Fax Number : 303-205-0073
Authorized Official
Title or Position : ADMIN
Name : MOTOLANI OWOLABI
Credential :
Telephone Number : 814-722-1559
Provider Enumeration Date : 03/23/2026
Last Update Date : 03/23/2026

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Directions to “LIMELIGHT ASSISTED LIVING - PUEBLO LLC ” Practice Location

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