Provider Demographics
NPI:1043081946
Name:RED ROCK RECOVERY CENTERS LLC
Entity Type:Organization
Organization Name:RED ROCK RECOVERY CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:HENLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-719-1097
Mailing Address - Street 1:PO BOX 261029
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-9029
Mailing Address - Country:US
Mailing Address - Phone:888-719-1097
Mailing Address - Fax:720-545-9080
Practice Address - Street 1:8805 W 14TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-4848
Practice Address - Country:US
Practice Address - Phone:888-719-1097
Practice Address - Fax:720-545-9080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder