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NPI Code Detail

MEDICARE: MOUNTAIN VIEW RECOVERY CENTER LLC

MEDICARE: MOUNTAIN VIEW RECOVERY CENTER 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 : 1912460056
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOUNTAIN VIEW RECOVERY CENTER LLC
Provider Business Mailing Address
First Line : 5475 MARK DABLING BLVD STE 102
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-3847
Country : US
Telephone Number : 973-277-5359
Fax Number : 928-441-1686
Provider Business Practice Location Address
First Line : 5475 MARK DABLING BLVD STE 102
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-3847
Country : US
Telephone Number : 973-277-5359
Fax Number : 928-441-1686
Authorized Official
Title or Position : OPERATING OFFICER
Name : PAUL COVELLI
Credential :
Telephone Number : 719-651-7584
Provider Enumeration Date : 04/06/2019
Last Update Date : 03/14/2022

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Directions to “MOUNTAIN VIEW RECOVERY CENTER LLC ” Practice Location

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