MEDICARE: DENVER RECOVERY GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0401X	Addiction Medicine (Family Medicine) Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407476021
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENVER RECOVERY GROUP LLC

Provider Business Mailing Address
First Line	:	2822 E COLFAX AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-1507
Country	:	US
Telephone Number	:	303-953-2299
Fax Number	:	303-953-8830

Provider Business Practice Location Address
First Line	:	8790 W COLFAX AVE STE 90
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80215-4025
Country	:	US
Telephone Number	:	720-750-8137
Fax Number	:	303-953-8830

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	KARLA CHAVEZ
Credential	:
Telephone Number	:	575-993-5225

Provider Enumeration Date	:	04/23/2020
Last Update Date	:	04/23/2020

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Directions to “DENVER RECOVERY GROUP LLC ” Practice Location

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