Healthcare Provider Details

I. General information

NPI: 1679449052
Provider Name (Legal Business Name): BDR RECOVERY HOLDINGS 11 LINCOLN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2025
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 LINCOLN ST
ROCHESTER NH
03867-3008
US

IV. Provider business mailing address

PO BOX 67013
CHESTNUT HILL MA
02467-0001
US

V. Phone/Fax

Practice location:
  • Phone: 603-699-9000
  • Fax:
Mailing address:
  • Phone: 603-699-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. SCOTT D CARTER
Title or Position: MANAGER
Credential:
Phone: 603-699-9000