Healthcare Provider Details

I. General information

NPI: 1629775317
Provider Name (Legal Business Name): PALMS RECOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 02/13/2023
Certification Date: 02/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

287 TURNPIKE RD
WESTBOROUGH MA
01581-2856
US

IV. Provider business mailing address

287 TURNPIKE RD
WESTBOROUGH MA
01581-2856
US

V. Phone/Fax

Practice location:
  • Phone: 603-440-8618
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DENNIS THERIAULT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 603-440-8618