Organization
LEASE ON LIFE, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD C KOONS (ADMINISTRATOR)
(719) 351-9400
Entity
Organization
Contact information
Practice address
1586 S 21ST ST STE 11, COLORADO SPRINGS, CO 80904-4260
(719) 351-9400
Mailing address
1586 S 21ST ST STE 11, COLORADO SPRINGS, CO 80904-4260
(719) 351-9400
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04L111
HOME HEALTH CARE LICENSE
CO
Enumeration date
07/18/2022
Last updated
07/18/2022
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