Provider Demographics
NPI:1215754460
Name:LEMMONGRAS LLC
Entity type:Organization
Organization Name:LEMMONGRAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AYODELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-492-8449
Mailing Address - Street 1:1934 MACON ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-2540
Mailing Address - Country:US
Mailing Address - Phone:720-492-8449
Mailing Address - Fax:
Practice Address - Street 1:1934 MACON ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010-2540
Practice Address - Country:US
Practice Address - Phone:720-492-8449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-20
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health