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General NPI Number Information
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NPI Number | 1467350504
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Entity Type | Organization
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Legal Business Name | SHINE WELLNESS AND RECOVERY
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Dates
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Enumeration Date | 10/28/2026
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Last Update Date | 10/28/2026
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Provider Practice Location Address
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Address Line | 605 BROADWAY STE 3A
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City | SAUGUS
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State | MA
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Zip | 01906-3200
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Country | US
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Telephone | 617-777-6238
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Fax | 781-558-1196
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Provider Business Mailing Address
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Address Line | 605 BROADWAY STE 3A
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City | SAUGUS
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State | MA
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Zip | 01906-3200
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Country | US
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Telephone | 617-777-6238
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Fax | 781-558-1196
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JOSEPH CLIFTON LACHANCE
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Credential |
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Telephone | 617-777-6238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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