Provider Demographics
NPI:1003271503
Name:LIFTING SPIRITS LLC
Entity Type:Organization
Organization Name:LIFTING SPIRITS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SEARCH
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:719-488-1415
Mailing Address - Street 1:755 HIGHWAY 105 UNIT 26
Mailing Address - Street 2:
Mailing Address - City:PALMER LAKE
Mailing Address - State:CO
Mailing Address - Zip Code:80133-9055
Mailing Address - Country:US
Mailing Address - Phone:719-488-1415
Mailing Address - Fax:719-488-1419
Practice Address - Street 1:755 HIGHWAY 105 UNIT 26
Practice Address - Street 2:
Practice Address - City:PALMER LAKE
Practice Address - State:CO
Practice Address - Zip Code:80133-9055
Practice Address - Country:US
Practice Address - Phone:719-488-1415
Practice Address - Fax:719-488-1419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-28
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO261QA0600X261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care