Healthcare Provider Details

I. General information

NPI: 1073396537
Provider Name (Legal Business Name): MR. ROBERT LHEUREUX
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2023
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 SHATTUCK WAY
NEWINGTON NH
03801-7879
US

IV. Provider business mailing address

9 MORNING GLORY LN
ROCHESTER NH
03868-8755
US

V. Phone/Fax

Practice location:
  • Phone: 603-436-0448
  • Fax:
Mailing address:
  • Phone: 207-329-9354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: