NPIMap

Organization Active NPI

Recovery Village at Palmer Lake, LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Colorado Springs, CO
National Provider Identifier
1104742469
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
RECOVERY VILLAGE AT PALMER LAKE, LLC
Practice address
6189 Lehman Dr Ste 102
Colorado Springs, CO 80918-5409
Phone
(754) 300-3120
Fax
(888) 919-4431
NPI assigned
Jun 29, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Authorized official

Name
Belina Surujon
Title
VP Contracting & Licensing
Phone
(754) 300-3120

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

6189 Lehman Dr Ste 102
Colorado Springs, CO 80918-5409

Mailing address

2200 N Commerce Pkwy Ste 200
Weston, FL 33326-3258
Phone (754) 300-3120

Other names 1

  • The Recovery Village Colorado Springs Outpatient Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Recovery Village at Palmer Lake LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1782691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782691200000",
    "number": "1104742469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 N COMMERCE PKWY STE 200",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333263258",
            "telephone_number": "754-300-3120",
            "fax_number": "888-919-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6189 LEHMAN DR STE 102",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809185409",
            "telephone_number": "754-300-3120",
            "fax_number": "888-919-4431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECOVERY VILLAGE AT PALMER LAKE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-29",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A",
        "authorized_official_last_name": "SURUJON",
        "authorized_official_first_name": "BELINA",
        "authorized_official_title_or_position": "VP CONTRACTING & LICENSING",
        "authorized_official_telephone_number": "754-300-3120"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Recovery Village Colorado Springs Outpatient Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; 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.