Provider Demographics
NPI:1205499852
Name:CONNECT GROW THRIVE
Entity type:Organization
Organization Name:CONNECT GROW THRIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONTESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LENGEFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-484-9005
Mailing Address - Street 1:4709 SPRINGER DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-8926
Mailing Address - Country:US
Mailing Address - Phone:970-484-9005
Mailing Address - Fax:
Practice Address - Street 1:4709 SPRINGER DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-8926
Practice Address - Country:US
Practice Address - Phone:970-484-9005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-19
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care