NPIMap

Organization Active NPI

Banyan Castle Rock, LLC

  • Substance Abuse Rehabilitation Facility
  • Castle Rock, CO
National Provider Identifier
1760244149
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
BANYAN CASTLE ROCK, LLC
Practice address
1055 S Perry St
Castle Rock, CO 80104-1949
Phone
(303) 381-8340
Fax
(303) 381-8341
NPI assigned
Jan 30, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Authorized official

Name
John Sory
Title
Ceo
Phone
(954) 533-7705

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Psychiatric Hospital 283Q00000X
Psychiatric Residential Treatment Facility 323P00000X
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

1055 S Perry St
Castle Rock, CO 80104-1949

Mailing address

225 N Federal Hwy
Pompano Beach, FL 33062-4319
Phone (954) 533-7705

Other identifiers 1

IdentifierTypeStateIssuer
9000235561MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Banyan Castle Rock LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747094400000",
    "number": "1760244149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N FEDERAL HWY",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330624319",
            "telephone_number": "954-533-7705",
            "fax_number": "954-781-7173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 S PERRY ST",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801041949",
            "telephone_number": "303-381-8340",
            "fax_number": "303-381-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANYAN CASTLE ROCK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-30",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A",
        "authorized_official_last_name": "SORY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-533-7705"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000235561",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.