| NPI | 1710876545 |
|---|---|
| Former Legal Business Name | IRONWOOD RECOVERY COLLECTIVE LLC |
| Entity Type | Organization |
| Authorized Contact | JIM GLOVER Owner 123-456-7890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103T00000X Psychologist | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2025-06-27 |
| Last Update Date | 2025-07-16 |