Provider Demographics
NPI:1013532027
Name:LIMELIGHT SUPPORT SERVICES LLC
Entity Type:Organization
Organization Name:LIMELIGHT SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MOTOLANI
Authorized Official - Middle Name:
Authorized Official - Last Name:OWOLABI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-722-1559
Mailing Address - Street 1:4751 TRAILS EDGE LN
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-7319
Mailing Address - Country:US
Mailing Address - Phone:814-722-1559
Mailing Address - Fax:
Practice Address - Street 1:20732 SCENIC PARK DR
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-3175
Practice Address - Country:US
Practice Address - Phone:814-722-1559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-15
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services