Provider Demographics
NPI:1215711817
Name:PARADIGM RECOVERY LLC
Entity type:Organization
Organization Name:PARADIGM RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GENO
Authorized Official - Middle Name:
Authorized Official - Last Name:SHVEDOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-989-0025
Mailing Address - Street 1:14109 E EXPOSITION AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-2523
Mailing Address - Country:US
Mailing Address - Phone:720-989-0025
Mailing Address - Fax:
Practice Address - Street 1:14707 E 2ND AVE STE 250
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8913
Practice Address - Country:US
Practice Address - Phone:720-989-0025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-23
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility