Provider Demographics
NPI:1932596889
Name:DENVER RECOVERY GROUP LLC
Entity Type:Organization
Organization Name:DENVER RECOVERY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM SPONSOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-953-2299
Mailing Address - Street 1:2822 E COLFAX AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-1507
Mailing Address - Country:US
Mailing Address - Phone:303-953-2299
Mailing Address - Fax:303-953-8830
Practice Address - Street 1:2822 E COLFAX AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1507
Practice Address - Country:US
Practice Address - Phone:303-953-2299
Practice Address - Fax:303-953-8830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadoneGroup - Single Specialty
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000147792Medicaid
CO64322882Medicaid