BOLDER LIFE
NPI 1376093898
Substance Abuse Rehabilitation Facility in Boulder, CO
NPI Status: Active since October 07, 2016
Contact Information
2429 BROADWAY ST
BOULDER, CO
ZIP 80304
Phone: (720) 739-6500
Fax: (720) 204-3930
- Organization
- Substance Abuse Rehabilitation Facility
- CLIA Number: 06D2134210
- CLIA Cert. Type: Ancillary Testing Site in Health Care Center
- CLIA Exp. Date: 07-26-2025
About BOLDER LIFE
This page provides the complete NPI Profile along with additional information for Bolder Life, a provider established in Boulder, Colorado operating as a Substance Abuse Rehabilitation Facility. The healthcare provider is registered in the NPI registry with number 1376093898 assigned on October 2016. The practitioner's primary taxonomy code is 324500000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as Bolder Life. The authorized official of this NPI record is Mary Wilson (Business Office Manager)
- NPI
- 1376093898
- Provider Legal Name
- BOULDER INTEGRATED HEALTH LLC
- Other Organization Name
- BOLDER LIFE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 2429 BROADWAY ST BOULDER, CO 80304
- Location Phone
- (720) 739-6500
- Location Fax
- (720) 204-3930
- Mailing Address
- 2429 BROADWAY ST BOULDER, CO 80304
- Mailing Phone
- (720) 739-6500
- Mailing Fax
- (720) 204-3930
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-07-2016
- Last Update Date
- 09-10-2021
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Substance Abuse Rehabilitation Facility
- Taxonomy Code
- 324500000X
- Type
- Residential Treatment Facilities
- Taxonomy Description
- A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 06D2134210
- Facility Type
- Ancillary Testing Site in Health Care Center
- Certificate Effective Date
- July 27, 2023
- Certificate Expiration Date
- July 26, 2025
- Laboratory Director
- DR. IAONNUS A. MALIDELIS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Bolder Life to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 7 | 6 | 0 | 9 | 3 | 8 | 9 | 8 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 14 | 6 | 0 | 9 | 6 | 8 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 4 + 6 + 0 + 9 + 6 + 8 + 1 + 8 + 24 = 72 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 72 = 8 | 8 | ||||||||
The NPI number 1376093898 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1982249678 | STEPHANIE ADDISS Individual | Counselor (Mental Health) | 2429 BROADWAY ST BOULDER, CO 80304 (949) 241-2220 |
| 1528734498 | KATHLEEN CLARE MCCARTHY MA, LPCC, LAC Individual | Counselor (Addiction (Substance Use Disorder)) | 2429 BROADWAY ST BOULDER, CO 80304 (720) 739-6500 |
| 1447920434 | DR. BRITTANY NICOLE RUBIN PSYD Individual | Psychologist (Clinical) | 2429 BROADWAY ST BOULDER, CO 80304 (720) 739-6500 |
| 1386396620 | DAKOTAH C ACOSTA MA Individual | Counselor (Mental Health) | 2429 BROADWAY ST BOULDER, CO 80304 (720) 739-6500 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1376093898, enumerated in the NPI registry as an "organization" on October 07, 2016
The provider is located at 2429 Broadway St Boulder, Co 80304 and the phone number is (720) 739-6500
This medical organization specializes in Substance Abuse Rehabilitation Facility with taxonomy code 324500000X
The provider's CLIA number is 06D2134210 for a "ancillary testing site in health care center" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on October 07, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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