Healthcare Provider Details

I. General information

NPI: 1801751599
Provider Name (Legal Business Name): PATHFINDER RECOVERY NH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1087 ELM ST STE 309
MANCHESTER NH
03101-1849
US

IV. Provider business mailing address

249 HARTLAND RD
WEST GRANBY CT
06090-1012
US

V. Phone/Fax

Practice location:
  • Phone: 646-319-4150
  • Fax:
Mailing address:
  • Phone: 646-319-4150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL T BRUNK
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 646-319-4150