NPIMap

Organization Active NPI

Jaywalker Lodge Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Carbondale, CO
National Provider Identifier
1972901080
Registry record updated Jun 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
JAYWALKER LODGE INC
Practice address
725 Main St
Carbondale, CO 81623
Phone
(970) 704-9292
NPI assigned
Dec 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2020

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

725 Main St
Carbondale, CO 81623

Mailing address

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

Other practice location 1

811 Main Ct
Carbondale, CO 81623-1851
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.

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": "1417737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593129600000",
    "number": "1972901080",
    "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": "725 MAIN ST",
            "city": "CARBONDALE",
            "state": "CO",
            "postal_code": "81623",
            "telephone_number": "970-704-9292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "811 Main Ct",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "CO",
            "postal_code": "816231851",
            "country_code": "US",
            "telephone_number": "970-704-9292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JAYWALKER LODGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-05",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A",
        "authorized_official_last_name": "WINSLOW",
        "authorized_official_first_name": "LAURI",
        "authorized_official_title_or_position": "DIRECTOR OF INSURANCE",
        "authorized_official_telephone_number": "970-704-9292"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "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 Jun 26, 2020; 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.