Healthcare Provider Details

I. General information

NPI: 1235923939
Provider Name (Legal Business Name): OUR HOUSE RECOVERY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 9TH AVE STE C
LONGMONT CO
80501-0002
US

IV. Provider business mailing address

5505 VALMONT RD LOT 285
BOULDER CO
80301-2929
US

V. Phone/Fax

Practice location:
  • Phone: 720-584-6999
  • Fax:
Mailing address:
  • Phone: 720-584-6999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. HAROLD NIEDZIELSKI
Title or Position: FOUNDER/CEO
Credential:
Phone: 720-584-6999