Organization
LIGHTHOUSE RECOVERY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD RUVINS (PROGRAM DIRECTOR)
(720) 934-1122
Entity
Organization
Contact information
Practice address
5370 CARR ST, ARVADA, CO 80002-3525
(855) 415-0034
(303) 484-4024
Mailing address
6630 E HAMPDEN AVE, DENVER, CO 80224-3004
(720) 934-6070
(303) 484-4024
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
12/06/2021
Last updated
12/06/2022
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