Healthcare Provider Details

I. General information

NPI: 1598283806
Provider Name (Legal Business Name): NAVIGATING RECOVERY OF THE LAKES REGION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2017
Last Update Date: 09/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 S MAIN ST STE 302
LACONIA NH
03246-3723
US

IV. Provider business mailing address

77 NORTHEASTERN BLVD STE C
NASHUA NH
03062-3128
US

V. Phone/Fax

Practice location:
  • Phone: 603-524-5939
  • Fax:
Mailing address:
  • Phone: 603-882-3616
  • Fax: 603-595-7414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JESSICA KEARNS
Title or Position: CREDENTIALER
Credential:
Phone: 603-882-3616