Organization
LIFE RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX CASTRO (CLINICAL DIRECTOR)
(303) 525-4179
Entity
Organization
Contact information
Practice address
11658 HURON ST, SUITE 400, NORTHGLENN, CO 80234-2919
(303) 252-4179
Mailing address
9028 GALE BLVD UNIT 1, THORNTON, CO 80260-4939
(720) 044-0426
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740608959
—
CO
Enumeration date
03/09/2017
Last updated
07/21/2022
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