Healthcare Provider Details

I. General information

NPI: 1669731022
Provider Name (Legal Business Name): RECOVERY SYSTEMS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2012
Last Update Date: 08/03/2021
Certification Date: 12/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

839 S CIRCLE DR
COLO SPGS CO
80910-2326
US

IV. Provider business mailing address

839 S CIRCLE DR
COLO SPGS CO
80910-2326
US

V. Phone/Fax

Practice location:
  • Phone: 719-578-5433
  • Fax: 719-578-5434
Mailing address:
  • Phone: 719-578-5433
  • Fax: 719-578-5434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number148300
License Number StateCO

VIII. Authorized Official

Name: MRS. LAURA CATHERINE SWAIN
Title or Position: PRES/DIRECTOR
Credential: CACIII
Phone: 719-578-5433