Provider Demographics
NPI:1629608401
Name:VANTAGE PLUS INC.
Entity Type:Organization
Organization Name:VANTAGE PLUS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ENRICA
Authorized Official - Middle Name:JOLYUN
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-409-9104
Mailing Address - Street 1:6825 E TENNESSEE AVE STE 445
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-1679
Mailing Address - Country:US
Mailing Address - Phone:720-280-0807
Mailing Address - Fax:
Practice Address - Street 1:6825 E TENNESSEE AVE STE 445
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-1679
Practice Address - Country:US
Practice Address - Phone:720-280-0807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management