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NPI Code Detail

MEDICARE: PARADIGM RECOVERY LLC

MEDICARE: PARADIGM RECOVERY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number : 1508703513
Entity Type Code : Organization
Provider Name (Legal Business Name) : PARADIGM RECOVERY LLC
Provider Business Mailing Address
First Line : 14109 E EXPOSITION AVE
Second Line :
City : AURORA
State : CO
Zip : 80012-2523
Country : US
Telephone Number : 720-989-0025
Fax Number :
Provider Business Practice Location Address
First Line : 2041 PEARL ST
Second Line :
City : BOULDER
State : CO
Zip : 80302-4429
Country : US
Telephone Number : 720-989-0025
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : YEVGENIY SHVEDOV
Credential :
Telephone Number : 720-989-0025
Provider Enumeration Date : 04/29/2026
Last Update Date : 04/29/2026

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