Healthcare Provider Details

I. General information

NPI: 1639926231
Provider Name (Legal Business Name): LAUREN RACHEL MANZO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2024
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6509 S SANTA FE DR
LITTLETON CO
80120-2910
US

IV. Provider business mailing address

116 INVERNESS DR E SUITE 105
ENGLEWOOD CO
80112-5125
US

V. Phone/Fax

Practice location:
  • Phone: 303-730-8858
  • Fax:
Mailing address:
  • Phone: 303-730-8858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: