Provider Demographics
NPI:1699481952
Name:A NEW OUTLOOK RECOVERY SERVICES LLC
Entity type:Organization
Organization Name:A NEW OUTLOOK RECOVERY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:SAP, MAC, LAC
Authorized Official - Phone:303-798-2196
Mailing Address - Street 1:9200 E MINERAL AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3412
Mailing Address - Country:US
Mailing Address - Phone:303-798-2196
Mailing Address - Fax:303-730-2418
Practice Address - Street 1:9200 E MINERAL AVE STE 250
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3412
Practice Address - Country:US
Practice Address - Phone:303-798-2196
Practice Address - Fax:303-730-2418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000178573Medicaid