NPIMap

Organization Active NPI

Jaywalker Lodge, LLC

  • Substance Abuse Rehabilitation Facility
  • Carbondale, CO
National Provider Identifier
1750657482
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
1548-01 Issued in CO
Legal business name
JAYWALKER LODGE, LLC
Practice address
811 Main CT
Carbondale, CO 81623-1851
Phone
(970) 704-9292
NPI assigned
Mar 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Authorized official

Name
Lauri A Winslow
Title
Director of Insurance
Phone
(970) 704-9292

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 1548-01 CO Primary

Addresses

Primary practice location

811 Main CT
Carbondale, CO 81623-1851

Mailing address

PO Box 969
Carbondale, CO 81623-0969
Phone (970) 704-9292

Other practice location 1

35 N 7th St
Carbondale, CO 81623-1901
Phone (970) 704-9292

National Provider Directory

National Provider Directory
Tax ID family
Jaywalker Lodge Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

725 Main St
Carbondale, CO 81623
Phone (970) 704-9292

811 Main Ct
Carbondale, CO 81623
Phone (970) 486-1440

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741564800000",
    "number": "1750657482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 969",
            "city": "CARBONDALE",
            "state": "CO",
            "postal_code": "816230969",
            "telephone_number": "970-704-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 MAIN CT",
            "city": "CARBONDALE",
            "state": "CO",
            "postal_code": "816231851",
            "telephone_number": "970-704-9292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 N 7th St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "CO",
            "postal_code": "816231901",
            "country_code": "US",
            "telephone_number": "970-704-9292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JAYWALKER LODGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-27",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A",
        "authorized_official_last_name": "WINSLOW",
        "authorized_official_first_name": "LAURI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF INSURANCE",
        "authorized_official_telephone_number": "970-704-9292"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CO",
            "license": "1548-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.