Provider Demographics
NPI:1093389470
Name:GOLDEN PEAK RECOVERY
Entity Type:Organization
Organization Name:GOLDEN PEAK RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NURYS
Authorized Official - Middle Name:
Authorized Official - Last Name:PUENTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-694-8619
Mailing Address - Street 1:2305 S FENTON DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-3975
Mailing Address - Country:US
Mailing Address - Phone:855-694-8619
Mailing Address - Fax:305-930-7437
Practice Address - Street 1:2305 S FENTON DR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-3975
Practice Address - Country:US
Practice Address - Phone:855-694-8619
Practice Address - Fax:305-930-7437
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOLDEN PEAK RECOVERY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility