MEDICARE: HEALING BIRCH RECOVERY LLC DBA ARCHANGEL CENTERS CENTRAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1326903683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING BIRCH RECOVERY LLC DBA ARCHANGEL CENTERS CENTRAL

Provider Business Mailing Address
First Line	:	44 APPLE ST STE 3
Second Line	:
City	:	TINTON FALLS
State	:	NJ
Zip	:	07724-2672
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	44 APPLE ST STE 3
Second Line	:
City	:	TINTON FALLS
State	:	NJ
Zip	:	07724-2672
Country	:	US
Telephone Number	:	561-252-9389
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SAMANTHA HEWETT
Credential	:
Telephone Number	:	561-252-9389

Provider Enumeration Date	:	12/18/2025
Last Update Date	:	12/18/2025

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