MIKE'S PLACE LLC – NPI #1043818719
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

MIKE'S PLACE LLC is a community based residential treatment facility located in CARBONDALE, CO. NPPES has assigned the NPI number 1043818719 to MIKE'S PLACE LLC on October 14, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MIKE'S PLACE LLC below.

NPI Profile for
MIKE'S PLACE LLC

NPI Number
1043818719
Enumeration Date

(more than 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MIKE'S PLACE LLC
Primary location
325 GARFIELD AVENUE
CARBONDALE, CO 81623
Phone: (970) 319-8496 Fax:
Mailing address
323 GARFIELD AVENUE
CARBONDALE, CO 81623
Phone: (970) 319-8496 Fax:
Organization Subpart
No
Authorized Official
REBECCA YOUNG
DIRECTOR
Phone: (970) 319-8496
Updated
Certification Date
Oct 14, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for MIKE'S PLACE LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDCO48808717
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.