Healthcare Provider Details

I. General information

NPI: 1174432504
Provider Name (Legal Business Name): RECOVERED HUMANS WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2481 NYSSA DR
LOVELAND CO
80538-3276
US

IV. Provider business mailing address

2481 NYSSA DR
LOVELAND CO
80538-3276
US

V. Phone/Fax

Practice location:
  • Phone: 601-334-3084
  • Fax:
Mailing address:
  • Phone:
  • 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 Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LAURA BURKHALTER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 601-334-3084