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FRIENDSHIP HOUSE AT THE HOME
NPI 1073754693
Assisted Living Facility in Canon City, CO

Active since March 11, 2009CLIA 06D2231606 · Waiver
1020 N 15TH ST, CANON CITY, CO 81212(719) 275-7451 Get Directions Write a Review

NPPES record last updated: March 11, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Friendship House At The Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FRIENDSHIP HOUSE AT THE HOME (NPI 1073754693) is a healthcare organization registered as an assisted living facility in Canon City, Colorado and active in the NPI registry since March 2009. The organization holds a CLIA Waiver certificate valid through August 3, 2027 and lists Dennis G Prather, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1073754693
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameIOOF GRAND LODGE OF COLORADO
Location Address1020 N 15TH STCanon City, CO 81212-2344
Mailing Address1545 Phelps AveCanon City, CO 81212-4650 · (719) 275-7451
Phone(719) 275-7451
Organization SubpartNo
Authorized OfficialDennis G PratherExecutive Director · (719) 275-7451
Enumeration DateMarch 11, 2009
✔ NPI 1073754693 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in CO · 23C967
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
1020 N 15TH ST, Canon City, CO 81212
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Other Names 1

Doing Business AsFriendship House At The Home

Other Identifiers 1

Medicaid23C967CO

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 06D2231606

Friendship House At The Home · Canon City, CO
Active · expires Aug 3, 2027
CLIA Number06D2231606
Laboratory TypeAssisted Living Facility
Certificate Effective DateAugust 4, 2025
Certificate Expiration DateAugust 3, 2027
Laboratory DirectorTisha R. Darnell
Laboratory Phone(719) 275-7451
Laboratory LocationFriendship House At The Home1020 N 15th St, Canon City, CO 81212
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ioof Grand Lodge Of Colorado's NPI number?

The NPI number for Ioof Grand Lodge Of Colorado is 1073754693. It was assigned to this organization in the NPPES registry on March 11, 2009. The provider is doing business as Friendship House At The Home.

Where is Ioof Grand Lodge Of Colorado located?

Ioof Grand Lodge Of Colorado is located at 1020 N 15th St, Canon City, CO 81212. The listed phone number is (719) 275-7451.

What is Ioof Grand Lodge Of Colorado's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Ioof Grand Lodge Of Colorado hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 06D2231606) is associated with this NPI, valid through August 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ioof Grand Lodge Of Colorado was last updated on March 11, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.