Provider Demographics
NPI:1366676264
Name:RICO, JAIME (BS)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:RICO
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 W DAVIES AVE N
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-5252
Mailing Address - Country:US
Mailing Address - Phone:303-347-6458
Mailing Address - Fax:
Practice Address - Street 1:61 W DAVIES AVE N
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-5252
Practice Address - Country:US
Practice Address - Phone:303-347-6458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator