Healthcare Provider Details

I. General information

NPI: 1770487472
Provider Name (Legal Business Name): BEAR BROOK BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 LONDONDERRY TPKE
HOOKSETT NH
03106-2011
US

IV. Provider business mailing address

26 LONDONDERRY TPKE
HOOKSETT NH
03106-2011
US

V. Phone/Fax

Practice location:
  • Phone: 856-952-5277
  • Fax:
Mailing address:
  • Phone: 856-952-5277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: JON DUFORD
Title or Position: CEO
Credential:
Phone: 856-952-5277