Healthcare Provider Details

I. General information

NPI: 1376298349
Provider Name (Legal Business Name): DENVER RECOVERY GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2022
Last Update Date: 02/17/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 N PARK AVE
MONTROSE CO
81401-3756
US

IV. Provider business mailing address

130 N PARK AVE
MONTROSE CO
81401-3756
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