Provider Demographics
NPI:1699277764
Name:LICE SOLUTIONS, LLC.
Entity type:Organization
Organization Name:LICE SOLUTIONS, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMI
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:MANTIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-319-6924
Mailing Address - Street 1:250 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5519
Mailing Address - Country:US
Mailing Address - Phone:303-319-6924
Mailing Address - Fax:
Practice Address - Street 1:1000 STONEWOOD DR STE 320
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8386
Practice Address - Country:US
Practice Address - Phone:724-620-3001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty