Healthcare Provider Details

I. General information

NPI: 1962581140
Provider Name (Legal Business Name): COLORADO RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2818 13TH ST
BOULDER CO
80304
US

IV. Provider business mailing address

2818 13TH ST
BOULDER CO
80304
US

V. Phone/Fax

Practice location:
  • Phone: 303-440-5140
  • Fax: 303-440-5144
Mailing address:
  • Phone: 303-440-5140
  • Fax: 303-440-5144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberAL-0094
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License NumberAL0094
License Number StateCO

VIII. Authorized Official

Name: DR. RICHARD WARNER WARNER
Title or Position: DIRECTOR
Credential: MD
Phone: 303-440-5140