Provider Demographics
NPI:1043671936
Name:LIFELONG, INC.
Entity Type:Organization
Organization Name:LIFELONG, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-582-3086
Mailing Address - Street 1:7175 W JEFFERSON AVE STE 4000
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80235-2336
Mailing Address - Country:US
Mailing Address - Phone:303-573-0839
Mailing Address - Fax:
Practice Address - Street 1:7175 W JEFFERSON AVE STE 4000
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235-2336
Practice Address - Country:US
Practice Address - Phone:303-573-0839
Practice Address - Fax:303-573-0849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-18
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW2081101YM0800X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty