Provider Demographics
NPI:1013537919
Name:DENVER RECOVERY GROUP LLC
Entity Type:Organization
Organization Name:DENVER RECOVERY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-993-5225
Mailing Address - Street 1:2822 E COLFAX AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-1507
Mailing Address - Country:US
Mailing Address - Phone:303-953-2299
Mailing Address - Fax:303-953-8830
Practice Address - Street 1:5330 MANHATTAN CIR STE H
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-4240
Practice Address - Country:US
Practice Address - Phone:720-536-5571
Practice Address - Fax:720-225-2067
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENVER RECOVERY GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-21
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000148295Medicaid