Healthcare Provider Details

I. General information

NPI: 1366274862
Provider Name (Legal Business Name): EMPOWER RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2024
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11186 LIVINGSTON DR
NORTHGLENN CO
80234-6200
US

IV. Provider business mailing address

1235 W 112TH AVE UNIT C
WESTMINSTER CO
80234-4347
US

V. Phone/Fax

Practice location:
  • Phone: 720-530-9809
  • Fax:
Mailing address:
  • Phone: 720-530-9809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: DANIEL OKODO
Title or Position: OPERATIONS DIRECTOR
Credential:
Phone: 720-317-5688