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RECOVERY VILLAGE AT PALMER LAKE, LLC
NPI 1336097120
Community Based Residential Treatment Facility, Mental Illness in Palmer Lake, CO

Active since March 18, 2026CLIA 06D2096238 · Waiver
443 HIGHWAY 105, PALMER LAKE, CO 80133(305) 785-5520(888) 919-4431 Get Directions Write a Review

NPPES record last updated: March 18, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Recovery Village At Palmer Lake, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RECOVERY VILLAGE AT PALMER LAKE, LLC (NPI 1336097120) is a healthcare organization registered as a community based residential treatment facility, mental illness in Palmer Lake, Colorado and active in the NPI registry since March 2026. The organization holds a CLIA Waiver certificate valid through May 18, 2027 and lists Belina Surujon, Vp Contracting & Licensing, as its authorized official.

NPPES Registry Identity

NPI1336097120
Entity TypeOrganization
Primary Taxonomy320800000X
Legal Business NameRECOVERY VILLAGE AT PALMER LAKE, LLC
Location Address443 HIGHWAY 105Palmer Lake, CO 80133-9003
Mailing Address2200 N Commerce Pkwy Ste 200Weston, FL 33326-3258 · (305) 785-5520 · Fax (888) 919-4431
Phone(305) 785-5520
Fax(888) 919-4431
Organization SubpartNo
Authorized OfficialBelina SurujonVp Contracting & Licensing · (305) 785-5520
Enumeration DateMarch 18, 2026
NPPES CertifiedMarch 18, 2026
✔ NPI 1336097120 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities
Taxonomy Code320800000X
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
443 HIGHWAY 105, Palmer Lake, CO 80133
Open in Google Maps ↗

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 06D2096238

Recovery Village At Palmer Lake, LLC · Palmer Lake, CO
Active · expires May 18, 2027
CLIA Number06D2096238
Laboratory TypeSubstance Abuse Treatment
Certificate Effective DateMay 19, 2025
Certificate Expiration DateMay 18, 2027
Laboratory DirectorDr. Neil Wilkey
Laboratory Phone(719) 955-1800
Laboratory LocationRecovery Village At Palmer Lake, LLC443 South Highway 105, Palmer Lake, CO 80133
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. CAROLINE HONORA STORK LSW, CCTP, CADC
Social Worker
443 HIGHWAY 105
PALMER LAKE, CO 80133
El Paso County (719) 884-0063
TESHINA CARTER LCSW
Social Worker (Clinical)
443 HIGHWAY 105
PALMER LAKE, CO 80133
El Paso County (719) 884-0063
SARAH SHEPHERD RD
Dietitian, Registered
443 HIGHWAY 105
PALMER LAKE, CO 80133
El Paso County (719) 660-2694
MICHELLE ROBERTS LSW
Counselor (Mental Health)
443 HIGHWAY 105
PALMER LAKE, CO 80133
El Paso County (719) 481-1800
RENAE CHALAINE HELMS MA, LPC, NCC
Counselor
443 HIGHWAY 105
PALMER LAKE, CO 80133
El Paso County (719) 955-1800
ELISSA MARIE MENDIETA LAC
Counselor (Addiction (Substance Use Disorder))
443 HIGHWAY 105
PALMER LAKE, CO 80133
El Paso County (719) 955-1800
RECOVERY VILLAGE AT PALMER LAKE, LLC
Substance Abuse Rehabilitation Facility
443 HIGHWAY 105
PALMER LAKE, CO 80133
El Paso County (719) 481-1800
MORGAN WOODWARD
Counselor (Mental Health)
443 HIGHWAY 105
PALMER LAKE, CO 80133
El Paso County (719) 955-1800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Recovery Village At Palmer Lake, LLC's NPI number?

The NPI number for Recovery Village At Palmer Lake, LLC is 1336097120. It was assigned to this organization in the NPPES registry on March 18, 2026.

Where is Recovery Village At Palmer Lake, LLC located?

Recovery Village At Palmer Lake, LLC is located at 443 Highway 105, Palmer Lake, CO 80133. The listed phone number is (305) 785-5520.

What is Recovery Village At Palmer Lake, LLC's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

Does Recovery Village At Palmer Lake, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 06D2096238) is associated with this NPI, valid through May 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Recovery Village At Palmer Lake, LLC was last updated on March 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.