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NPI Code Detail

MEDICARE: COLORADO ADDICTION RECOVERY SERVICES

MEDICARE: COLORADO ADDICTION RECOVERY SERVICES
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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number : 1689495863
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLORADO ADDICTION RECOVERY SERVICES
Provider Business Mailing Address
First Line : 4916 S BUCHANAN ST
Second Line :
City : AURORA
State : CO
Zip : 80016-5949
Country : US
Telephone Number : 973-277-5359
Fax Number :
Provider Business Practice Location Address
First Line : 18632 E COLUMBIA PL
Second Line :
City : AURORA
State : CO
Zip : 80013-2366
Country : US
Telephone Number : 973-277-5359
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF OPERATIONS
Name : BRYAN DISIMONE
Credential :
Telephone Number : 973-277-5359
Provider Enumeration Date : 10/21/2024
Last Update Date : 10/21/2024

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Directions to “COLORADO ADDICTION RECOVERY SERVICES ” Practice Location

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