Provider Demographics
NPI:1770131385
Name:YOUNG PEOPLE IN RECOVERY
Entity type:Organization
Organization Name:YOUNG PEOPLE IN RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, INSTITUTIONAL ADVANCEMENT
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERBST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-243-2264
Mailing Address - Street 1:1415 PARK AVE W
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2103
Mailing Address - Country:US
Mailing Address - Phone:720-600-4977
Mailing Address - Fax:
Practice Address - Street 1:1415 PARK AVE W
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-2103
Practice Address - Country:US
Practice Address - Phone:720-600-4977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health