Provider Demographics
NPI:1164906905
Name:CARMEL COMMUNITY LIVING CORPORATION
Entity Type:Organization
Organization Name:CARMEL COMMUNITY LIVING CORPORATION
Other - Org Name:OVERTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF DEVELOPMENT OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ORDWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-660-1844
Mailing Address - Street 1:11177 W 8TH AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-5520
Mailing Address - Country:US
Mailing Address - Phone:720-496-2605
Mailing Address - Fax:800-475-9083
Practice Address - Street 1:500 N RAINBOW BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-1061
Practice Address - Country:US
Practice Address - Phone:702-997-1025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-18
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care