The Pure Life Center, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

THE PURE LIFE CENTER, LLC

Practice address

2503 Walnut St
Boulder, CO 80302-5748

Phone

(970) 987-2583

NPI assigned

Sep 13, 2023

Last updated

Sep 13, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Scott William Lister, RNNPI 1396359162

Title

Ceo

Phone

(970) 987-2583

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Scott William Lister, RN

  • Addiction (Substance Use Disorder) Registered Nurse
  • Boulder, CO
  • NPI 1396359162
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1487431359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4275 W 107TH DR",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800311994",
            "telephone_number": "970-987-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2503 WALNUT ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025748",
            "telephone_number": "970-987-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PURE LIFE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A",
        "authorized_official_last_name": "LISTER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "970-987-2583",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Boulder, CO
• Providers in Boulder, CO by specialty
• Substance Abuse Rehabilitation Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.