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Organization
LAKE RECOVERY CENTER
Active
Organization
LAKE RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN DUNCAN (CEO)
(419) 465-5000
Entity
Organization
Contact information
Practice address
1330 QUAIL LAKE LOOP, SUITE 200, COLORADO SPRINGS, CO 80906-4651
(719) 465-5000
Mailing address
1330 QUAIL LAKE LOOP, SUITE 200, COLORADO SPRINGS, CO 80906-4651
(719) 465-5000
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/16/2013
Last updated
09/16/2013
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