# MANGO HOUSE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508349101
- **Authorized official:** JENNIFER RUDDER (OPERATIONS DIRECTOR)
- **Authorized official phone:** (720) 819-7194

## Contact information

- **Practice address:** 10180 E COLFAX AVE STE 150, AURORA, CO 80010-5015
- **Practice address phone:** (720) 819-7194
- **Mailing address:** 12702 W VIRGINIA AVE, LAKEWOOD, CO 80228-2611
- **Mailing address phone:** (720) 819-7194

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/10/2018
- **Last updated:** 06/24/2021