Provider Demographics
NPI:1710415302
Name:FORWARD LIVING CORPORATION
Entity Type:Organization
Organization Name:FORWARD LIVING CORPORATION
Other - Org Name:FORWARD LIVING CORPORATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LAPIOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-460-7629
Mailing Address - Street 1:4102 NYALA DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922-2436
Mailing Address - Country:US
Mailing Address - Phone:719-460-7629
Mailing Address - Fax:
Practice Address - Street 1:4102 NYALA DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80922-2436
Practice Address - Country:US
Practice Address - Phone:719-460-7629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care