Provider Demographics
NPI:1174258792
Name:LEASE ON LIFE, LTD.
Entity Type:Organization
Organization Name:LEASE ON LIFE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:KOONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-351-9400
Mailing Address - Street 1:1586 S 21ST ST STE 11
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-4260
Mailing Address - Country:US
Mailing Address - Phone:719-351-9400
Mailing Address - Fax:
Practice Address - Street 1:1586 S 21ST ST STE 11
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-4260
Practice Address - Country:US
Practice Address - Phone:719-351-9400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04L111OtherHOME HEALTH CARE LICENSE