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General NPI Number Information
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NPI Number | 1932748274
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Entity Type | Organization
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Legal Business Name | POWER OF RECOVERY LLC
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Dates
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Enumeration Date | 01/03/2020
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 385 BROADWAY STE 203
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City | REVERE
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State | MA
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Zip | 02151-3049
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Country | US
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Telephone | 781-629-4609
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Fax |
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Provider Business Mailing Address
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Address Line | 649 BROADWAY
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City | MALDEN
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State | MA
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Zip | 02148-2041
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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 | OWNER/OPERATOR
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Name | MATTHEW POWERS
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Credential |
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Telephone | 857-251-5047
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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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