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NPI Code Detail

MEDICARE: GROUPS - RECOVER TOGETHER CALIFORNIA, INC., A PROFESSIONAL MEDICAL COR

MEDICARE: GROUPS - RECOVER TOGETHER CALIFORNIA, INC., A PROFESSIONAL MEDICAL COR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0850XAdult Mental Health Clinic/Center

General Provider Information

NPI Number : 1386278729
Entity Type Code : Organization
Provider Name (Legal Business Name) : GROUPS - RECOVER TOGETHER CALIFORNIA, INC., A PROFESSIONAL MEDICAL COR
Provider Business Mailing Address
First Line : 111 S BEDFORD ST STE 205
Second Line :
City : BURLINGTON
State : MA
Zip : 01803-5145
Country : US
Telephone Number : 512-439-3547
Fax Number :
Provider Business Practice Location Address
First Line : 376 HARTNELL AVE STE A
Second Line :
City : REDDING
State : CA
Zip : 96002-1881
Country : US
Telephone Number : 800-683-8313
Fax Number :
Authorized Official
Title or Position : CEO
Name : COLLEEN NICEWICZ
Credential :
Telephone Number : 413-281-3035
Provider Enumeration Date : 02/25/2020
Last Update Date : 08/23/2022

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Directions to “GROUPS - RECOVER TOGETHER CALIFORNIA, INC., A PROFESSIONAL MEDICAL COR ” Practice Location

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