Healthcare Provider Details

I. General information

NPI: 1609798628
Provider Name (Legal Business Name): ANCHORLIGHT RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5968 S CLAYTON ST
CENTENNIAL CO
80121-2802
US

IV. Provider business mailing address

5968 S CLAYTON ST
CENTENNIAL CO
80121-2802
US

V. Phone/Fax

Practice location:
  • Phone: 716-536-0759
  • Fax:
Mailing address:
  • Phone: 716-536-0759
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State

VIII. Authorized Official

Name: ANUDEEP ARLA
Title or Position: PRESIDENT
Credential:
Phone: 716-536-0759