Organization
MANGO HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER RUDDER (OPERATIONS DIRECTOR)
(720) 819-7194
Entity
Organization
Contact information
Practice address
10180 E COLFAX AVE STE 150, AURORA, CO 80010-5015
(720) 819-7194
Mailing address
12702 W VIRGINIA AVE, LAKEWOOD, CO 80228-2611
(720) 819-7194
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/10/2018
Last updated
06/24/2021
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