Provider Demographics
NPI:1164286688
Name:THE LEMONADE HOUSE LLC
Entity Type:Organization
Organization Name:THE LEMONADE HOUSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:KONOPKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-272-6816
Mailing Address - Street 1:3312 CORTE DEL CRUCE
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-9546
Mailing Address - Country:US
Mailing Address - Phone:760-272-6816
Mailing Address - Fax:
Practice Address - Street 1:39402 COLONY UNION ST
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-7327
Practice Address - Country:US
Practice Address - Phone:760-272-6816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility