Healthcare Provider Details

I. General information

NPI: 1699541094
Provider Name (Legal Business Name): DENVER RECOVERY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1429 GRAND AVE # 102B
GLENWOOD SPRINGS CO
81601-3847
US

IV. Provider business mailing address

1429 GRAND AVE # 102B
GLENWOOD SPRINGS CO
81601-3847
US

V. Phone/Fax

Practice location:
  • Phone: 720-616-0049
  • Fax: 303-953-8830
Mailing address:
  • Phone: 720-616-0049
  • Fax: 303-953-8830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

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