Mobel Fadeyi

Key facts

NPI

1093379083

Entity type

Individual (NPI type 1)

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X

Practice address

318 Mt Wilson St
Brighton, CO 80601-6530

Phone

(720) 298-9114

NPI assigned

Apr 25, 2019

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

Other names

• Alpha Host Home Professional name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 10, 2025.

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1093379083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 MT WILSON ST",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806016530",
            "telephone_number": "720-298-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 MT WILSON ST",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806016530",
            "telephone_number": "720-298-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADEYI",
        "first_name": "MOBEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-25",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALPHA",
            "last_name": "HOME",
            "middle_name": "HOST",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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All providers in Brighton, CO · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Colorado