Healthcare Provider Details

I. General information

NPI: 1801424171
Provider Name (Legal Business Name): RECOVER TOGETHER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 08/23/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S BEDFORD ST STE 205
BURLINGTON MA
01803-5145
US

IV. Provider business mailing address

111 S BEDFORD ST STE 205
BURLINGTON MA
01803-5145
US

V. Phone/Fax

Practice location:
  • Phone: 512-439-3547
  • Fax:
Mailing address:
  • Phone: 512-439-3547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: COLLEEN NICEWICZ
Title or Position: CEO
Credential:
Phone: 413-281-3035