Provider Demographics
NPI:1962847160
Name:BOSTON HEALTH RECOVERY SERVICES, INC
Entity Type:Organization
Organization Name:BOSTON HEALTH RECOVERY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDOBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-710-8142
Mailing Address - Street 1:112 MARSTON ST
Mailing Address - Street 2:UNIT 201
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-2349
Mailing Address - Country:US
Mailing Address - Phone:978-710-8142
Mailing Address - Fax:978-431-8142
Practice Address - Street 1:112 MARSTON ST
Practice Address - Street 2:UNIT 201
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2349
Practice Address - Country:US
Practice Address - Phone:978-710-8142
Practice Address - Fax:978-431-8142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health