Provider Demographics
NPI:1063244788
Name:GROUPS RECOVER TOGETHER - NEW YORK LLC
Entity type:Organization
Organization Name:GROUPS RECOVER TOGETHER - NEW YORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:NICEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-281-3035
Mailing Address - Street 1:111 S BEDFORD ST STE 205
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-5145
Mailing Address - Country:US
Mailing Address - Phone:800-683-8313
Mailing Address - Fax:
Practice Address - Street 1:465 BROADWAY
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-4627
Practice Address - Country:US
Practice Address - Phone:800-683-8313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)