Provider Demographics
NPI:1598312241
Name:DENVER RECOVERY GROUP LLC
Entity Type:Organization
Organization Name:DENVER RECOVERY GROUP LLC
Other - Org Name:DENVER RECOVERY GROUP SOUTH
Other - Org Type:Doing Business As
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 1:72 E ARAPAHOE RD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-8001
Mailing Address - Country:US
Mailing Address - Phone:720-283-3055
Mailing Address - Fax:
Practice Address - Street 1:72 E ARAPAHOE RD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-8001
Practice Address - Country:US
Practice Address - Phone:720-283-3055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENVER RECOVERY GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-19
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO45130051Medicaid
CO45130051Medicaid