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General NPI Number Information
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NPI Number | 1639786445
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Entity Type | Organization
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Legal Business Name | EATING RECOVERY CENTER
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Dates
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Enumeration Date | 09/25/2020
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Last Update Date | 04/19/2025
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Provider Practice Location Address
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Address Line | 8140 E. 5TH AVE
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City | DENVER
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State | CO
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Zip | 80230
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Country | US
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Telephone | 877-825-8584
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Fax | 303-731-8144
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Provider Business Mailing Address
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Address Line | PO BOX 56181
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City | DENVER
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State | CO
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Zip | 80256
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Country | US
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Telephone | 303-825-8584
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Fax | 303-825-8587
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Authorized Official
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Title or Position | CONTRACTING & CREDENTIALING MANAGER
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Name | MARINA SHEPEL
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Credential |
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Telephone | 206-383-4781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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