Provider Demographics
NPI:1356750897
Name:RUE UNLIMITED LLC
Entity type:Organization
Organization Name:RUE UNLIMITED LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALETHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:NRCCS
Authorized Official - Phone:800-823-9086
Mailing Address - Street 1:13791 E RICE PL STE 143
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-1080
Mailing Address - Country:US
Mailing Address - Phone:800-823-9086
Mailing Address - Fax:877-440-7731
Practice Address - Street 1:13791 E RICE PL STE 143
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-1080
Practice Address - Country:US
Practice Address - Phone:800-823-9086
Practice Address - Fax:877-440-7731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-08
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000195614Medicaid