NPIMap

Organization Active NPI

Recovery Village at Palmer Lake, LLC

  • Substance Abuse Rehabilitation Facility
  • Palmer Lake, CO
National Provider Identifier
1356738132
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
RECOVERY VILLAGE AT PALMER LAKE, LLC
Practice address
443 Highway 105
Palmer Lake, CO 80133-9003
Phone
(719) 481-1800
NPI assigned
Apr 20, 2015
Last updated
May 11, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X NU Primary

Addresses

Primary practice location

443 Highway 105
Palmer Lake, CO 80133-9003

Mailing address

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

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.

Locations

443 Highway 105
Palmer Lake, CO 80133
Phone (719) 602-0914

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778457600000",
    "number": "1356738132",
    "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": "443 HIGHWAY 105",
            "city": "PALMER LAKE",
            "state": "CO",
            "postal_code": "801339003",
            "telephone_number": "719-481-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECOVERY VILLAGE AT PALMER LAKE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-20",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A",
        "authorized_official_last_name": "SURUJON",
        "authorized_official_first_name": "BELINA",
        "authorized_official_title_or_position": "LICENSING & CONTRACTING DIRECTOR",
        "authorized_official_telephone_number": "754-300-3120"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmer Lake, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.