Realize Recovery LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

REALIZE RECOVERY LLC

Practice address

3775 Iris Ave Ste 6
Boulder, CO 80301-2043

Phone

(512) 644-8598

NPI assigned

Aug 11, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Quddus Fujita Maus, MA, LPCNPI 1437790805

Title

Owner

Phone

(512) 644-8598

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Quddus Fujita Maus, LPC

  • Mental Health Counselor
  • Boulder, CO
  • NPI 1437790805
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1565481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565481600000",
    "number": "1003462623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3775 IRIS AVE STE 6",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012043",
            "telephone_number": "512-644-8598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 IRIS AVE STE 6",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012043",
            "telephone_number": "512-644-8598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REALIZE RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-11",
        "last_updated": "2019-08-11",
        "status": "A",
        "authorized_official_last_name": "FUJITA MAUS",
        "authorized_official_first_name": "QUDDUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-644-8598",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eugene Raykin
• Marisa Raymond, MS MPH CGC
• Sam Raymond, LPC, LAC
• Susanne I Raymond
• Jane V. Reagan, MED., RD
• Realm
• Whitfield Reaves, L.AC.
• Edward Reavey IV
• Nicole Marie Reavy, LPC
• David Michael Rebber, D.D.S.

• Substance Use Disorder Rehabilitation Clinic/Center in Boulder, CO
• Providers in Boulder, CO by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.