Healthcare Provider Details

I. General information

NPI: 1326903683
Provider Name (Legal Business Name): HEALING BIRCH RECOVERY LLC DBA ARCHANGEL CENTERS CENTRAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 APPLE ST STE 3
TINTON FALLS NJ
07724-2672
US

IV. Provider business mailing address

44 APPLE ST STE 3
TINTON FALLS NJ
07724-2672
US

V. Phone/Fax

Practice location:
  • Phone: 561-252-9389
  • 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: SAMANTHA HEWETT
Title or Position: CEO
Credential:
Phone: 561-252-9389