Provider Demographics
NPI:1982432688
Name:RENEWAL RECOVERY, LLC
Entity type:Organization
Organization Name:RENEWAL RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:P
Authorized Official - Last Name:COLLETT
Authorized Official - Suffix:
Authorized Official - Credentials:LADC1
Authorized Official - Phone:508-485-3541
Mailing Address - Street 1:41 WALCOTT VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-1303
Mailing Address - Country:US
Mailing Address - Phone:508-485-3541
Mailing Address - Fax:
Practice Address - Street 1:375 MAIN ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2518
Practice Address - Country:US
Practice Address - Phone:508-485-3541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty