Provider Demographics
NPI:1134493133
Name:EATING RECOVERY CENTER
Entity Type:Organization
Organization Name:EATING RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:303-478-1342
Mailing Address - Street 1:1830 FRANKLIN ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1128
Mailing Address - Country:US
Mailing Address - Phone:303-731-8871
Mailing Address - Fax:
Practice Address - Street 1:8190 E 1ST AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7211
Practice Address - Country:US
Practice Address - Phone:303-731-8871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YP2500X283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital