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NPI 1336749373ActiveOrganization· Assisted Living Facility· Lakewood, CO

Assisted Living Facility in Lakewood, Colorado, registered in NPPES in October 2020. The authorized official on file is Justin Bennett Wiley, Owner.

Overview

NPI1336749373
StatusActive
Entity typeOrganization
NPI issuedOct 29, 2020
Last updated in NPPESOct 29, 2020
Certified by providerOct 28, 2020

Specialties and licenses

TaxonomyCodeLicenseState
Assisted Living Facility Primary310400000X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Other assisted living facilities in Lakewood

All 36 assisted living facilities in Lakewood · All assisted living facilities in Colorado