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General NPI Number Information
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NPI Number | 1043141054
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Entity Type | Organization
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Legal Business Name | PROUD WALK RECOVERY SERVICES LLC
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Dates
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Enumeration Date | 05/27/2026
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Last Update Date | 05/27/2026
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Provider Practice Location Address
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Address Line | 962 S ZENO WAY
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City | AURORA
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State | CO
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Zip | 80017-3392
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Country | US
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Telephone | 720-713-0177
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 S JAMAICA CT STE 335
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City | AURORA
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State | CO
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Zip | 80014-4603
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | VINCENT NEAL
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Credential |
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Telephone | 720-713-0177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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