Provider Demographics
NPI:1457047631
Name:DENVER RECOVERY GROUP LLC
Entity Type:Organization
Organization Name:DENVER RECOVERY GROUP LLC
Other - Org Name:
Other - Org Type:
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 1:1801 W 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-2407
Mailing Address - Country:US
Mailing Address - Phone:720-616-0049
Mailing Address - Fax:303-955-8830
Practice Address - Street 1:1801 W 13TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-2407
Practice Address - Country:US
Practice Address - Phone:720-616-0049
Practice Address - Fax:303-955-8830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1776-09OtherSTATE OF CO