Healthcare Provider Details

I. General information

NPI: 1811448434
Provider Name (Legal Business Name): PASSAGES BEHAVIORAL HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2016
Last Update Date: 10/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 PINE STREET EXT UNIT B
NASHUA NH
03060-3275
US

IV. Provider business mailing address

3 PINE STREET EXT UNIT B
NASHUA NH
03060-3275
US

V. Phone/Fax

Practice location:
  • Phone: 603-577-0665
  • Fax: 603-204-5251
Mailing address:
  • Phone: 603-577-0665
  • Fax: 603-204-5251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LUCAS LUND
Title or Position: DIRECTOR
Credential: D.O.
Phone: 603-577-0665