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General NPI Number Information
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NPI Number | 1073906178
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Entity Type | Organization
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Legal Business Name | HOPEWELL RECOVERY SERVICES, LLC
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Dates
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Enumeration Date | 03/13/2015
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Last Update Date | 03/13/2015
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Provider Practice Location Address
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Address Line | 1107 WASHINGTON ST LINCOLN WOMEN'S HOUSE
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City | DORCHESTER
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State | MA
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Zip | 02124-5523
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Country | US
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Telephone | 508-857-5504
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Fax |
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Provider Business Mailing Address
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Address Line | 2510 CRANBERRY HWY
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City | WAREHAM
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State | MA
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Zip | 02571-1019
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Country | US
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Telephone | 508-857-5504
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. JIM MCCOY
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Credential |
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Telephone | 508-857-5504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State | MA
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