Healthcare Provider Details

I. General information

NPI: 1912527664
Provider Name (Legal Business Name): DENVER RECOVERY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2020
Last Update Date: 04/23/2020
Certification Date: 04/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2822 E COLFAX AVE
DENVER CO
80206-1507
US

IV. Provider business mailing address

2822 E COLFAX AVE
DENVER CO
80206-1507
US

V. Phone/Fax

Practice location:
  • Phone: 303-953-2299
  • Fax: 303-953-8830
Mailing address:
  • Phone: 303-953-2299
  • Fax: 303-953-8830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: KARLA CHAVEZ
Title or Position: BILLING MANAGER
Credential:
Phone: 575-993-5225