Provider Demographics
NPI:1306462965
Name:CRESENTE MENTES A LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:CRESENTE MENTES A LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CASE
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:720-429-4052
Mailing Address - Street 1:1692 W CANAL CIR UNIT 1034
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-4560
Mailing Address - Country:US
Mailing Address - Phone:720-429-4052
Mailing Address - Fax:
Practice Address - Street 1:1692 W CANAL CIR UNIT 1034
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-4560
Practice Address - Country:US
Practice Address - Phone:720-429-4052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Multi-Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech