Provider Demographics
NPI:1114584232
Name:SCW RECOVERY LLC
Entity Type:Organization
Organization Name:SCW RECOVERY LLC
Other - Org Name:SUMMIT WOMEN'S RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERAMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-899-5828
Mailing Address - Street 1:3801 E FLORIDA AVE STE 650
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-2562
Mailing Address - Country:US
Mailing Address - Phone:888-233-1553
Mailing Address - Fax:
Practice Address - Street 1:330 FIEDLER AVE
Practice Address - Street 2:STE 103
Practice Address - City:DILLON
Practice Address - State:CO
Practice Address - Zip Code:80435
Practice Address - Country:US
Practice Address - Phone:888-233-1553
Practice Address - Fax:720-282-5737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1832-01OtherOBH LICENSE NUMBER