Healthcare Provider Details

I. General information

NPI: 1720151830
Provider Name (Legal Business Name): MANCHESTER ALCOHOLISM REHABILITATION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 LAKE AVE STE 2
MANCHESTER NH
03103-2734
US

IV. Provider business mailing address

555 AUBURN ST
MANCHESTER NH
03103-4803
US

V. Phone/Fax

Practice location:
  • Phone: 603-622-3020
  • Fax:
Mailing address:
  • Phone: 603-622-3020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE KUHN
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 603-623-8863