Provider Demographics
NPI:1619422482
Name:ZESTY ENTERPRISES LLC
Entity Type:Organization
Organization Name:ZESTY ENTERPRISES LLC
Other - Org Name:LOVING LIFE HOST HOMES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-984-9960
Mailing Address - Street 1:6000 E EVANS AVE STE 3-111
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-5422
Mailing Address - Country:US
Mailing Address - Phone:720-984-9960
Mailing Address - Fax:720-645-2143
Practice Address - Street 1:6000 E EVANS AVE STE 3-111
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5422
Practice Address - Country:US
Practice Address - Phone:209-849-9607
Practice Address - Fax:720-645-2143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-22
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251C00000X, 343900000X, 376J00000X, 385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO55831885Medicaid
CO9000142475OtherHCBS LOCATION ID