Provider Demographics
NPI:1871004754
Name:PALO RECOVERY COUNSELING
Entity Type:Organization
Organization Name:PALO RECOVERY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:PALO
Authorized Official - Suffix:
Authorized Official - Credentials:MA LCDP
Authorized Official - Phone:401-484-0407
Mailing Address - Street 1:55 OPPER AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-2744
Mailing Address - Country:US
Mailing Address - Phone:401-793-1468
Mailing Address - Fax:401-484-0407
Practice Address - Street 1:55 OPPER AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02889-2744
Practice Address - Country:US
Practice Address - Phone:401-793-1468
Practice Address - Fax:401-484-0407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-18
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityGroup - Single Specialty