Provider Demographics
NPI:1063287845
Name:RECOVER COLORADO LLC
Entity type:Organization
Organization Name:RECOVER COLORADO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSING CONSULTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:BOOZAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-955-6507
Mailing Address - Street 1:5141 W 78TH AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80030-4622
Mailing Address - Country:US
Mailing Address - Phone:609-955-6507
Mailing Address - Fax:
Practice Address - Street 1:5141 W 78TH AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80030-4622
Practice Address - Country:US
Practice Address - Phone:561-379-3299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-21
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder