Provider Demographics
NPI:1215410469
Name:MANZANARARES, BEATRICE (CACII)
Entity Type:Individual
Prefix:
First Name:BEATRICE
Middle Name:
Last Name:MANZANARARES
Suffix:
Gender:F
Credentials:CACII
Other - Prefix:
Other - First Name:LILLIE
Other - Middle Name:
Other - Last Name:MANZANARES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CACII
Mailing Address - Street 1:9538 BURGUNDY CIR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-3583
Mailing Address - Country:US
Mailing Address - Phone:303-263-8457
Mailing Address - Fax:
Practice Address - Street 1:4195 S BROADWAY
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-4794
Practice Address - Country:US
Practice Address - Phone:303-806-0933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)