Healthcare Provider Details

I. General information

NPI: 1043141054
Provider Name (Legal Business Name): PROUD WALK RECOVERY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

962 S ZENO WAY
AURORA CO
80017-3392
US

IV. Provider business mailing address

3000 S JAMAICA CT STE 335
AURORA CO
80014-4603
US

V. Phone/Fax

Practice location:
  • Phone: 720-713-0177
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VINCENT NEAL
Title or Position: MANAGING MEMBER
Credential:
Phone: 720-713-0177