Provider Demographics
NPI:1215404249
Name:LIL FRIENDS LLC
Entity Type:Organization
Organization Name:LIL FRIENDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:303-358-9341
Mailing Address - Street 1:17857 W 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80007-7249
Mailing Address - Country:US
Mailing Address - Phone:303-229-9243
Mailing Address - Fax:303-484-3315
Practice Address - Street 1:805 BURBANK ST
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-1649
Practice Address - Country:US
Practice Address - Phone:303-358-9341
Practice Address - Fax:303-484-3315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-29
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1417476979Medicaid