Provider Demographics
NPI:1467841650
Name:ENGAGE WITH YOU LLC
Entity Type:Organization
Organization Name:ENGAGE WITH YOU LLC
Other - Org Name:ENGAGE WITHIN YOU LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMARAH
Authorized Official - Middle Name:LOURDES
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD, LPC
Authorized Official - Phone:720-355-3929
Mailing Address - Street 1:1777 S HARRISON ST STE 204
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3957
Mailing Address - Country:US
Mailing Address - Phone:720-355-3929
Mailing Address - Fax:303-317-3353
Practice Address - Street 1:1777 S HARRISON ST STE 204
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3957
Practice Address - Country:US
Practice Address - Phone:720-355-3929
Practice Address - Fax:303-317-3353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0012183261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO69327238Medicaid
CO1790037174OtherNPPES