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General NPI Number Information
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NPI Number | 1548083322
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Entity Type | Organization
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Legal Business Name | CLOVER BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 11/01/2024
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 321 BILLERICA RD UNIT 206
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City | CHELMSFORD
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State | MA
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Zip | 01824-4169
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Country | US
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Telephone | 978-216-7765
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Fax |
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Provider Business Mailing Address
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Address Line | 321 BILLERICA RD UNIT 206
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City | CHELMSFORD
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State | MA
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Zip | 01824-4169
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING
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Name | JONATHAN PENA
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Credential |
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Telephone | 973-986-1103
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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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