Healthcare Provider Details

I. General information

NPI: 1508703513
Provider Name (Legal Business Name): PARADIGM RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 PEARL ST
BOULDER CO
80302-4429
US

IV. Provider business mailing address

14109 E EXPOSITION AVE
AURORA CO
80012-2523
US

V. Phone/Fax

Practice location:
  • Phone: 720-989-0025
  • Fax:
Mailing address:
  • Phone: 720-989-0025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: YEVGENIY SHVEDOV
Title or Position: DIRECTOR
Credential:
Phone: 720-989-0025