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General NPI Number Information
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NPI Number | 1295639219
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Entity Type | Organization
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Legal Business Name | BOSTON INTEGRATED RECOVERY SERVICES LLC
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 288 WALNUT ST STE 412
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City | NEWTON
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State | MA
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Zip | 02460-2062
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Country | US
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Telephone | 724-747-3934
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Fax |
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Provider Business Mailing Address
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Address Line | 46 FAIRVIEW ST
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City | DEDHAM
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State | MA
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Zip | 02026-3254
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Country | US
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Telephone | 724-747-3934
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM CODY
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Credential | LICSW
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Telephone | 724-747-3934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | NULL
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