Healthcare Provider Details

I. General information

NPI: 1841878089
Provider Name (Legal Business Name): TERESA VARNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 03/30/2021
Certification Date: 03/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

865 ISLINGTON STREET SAFE HARBOR RECOVERY CENTER
PORTSMOUTH NH
03801
US

IV. Provider business mailing address

865 ISLINGTON STREET SAFE HARBOR RECOVERY CENTER
PORTSMOUTH NH
03801
US

V. Phone/Fax

Practice location:
  • Phone: 603-570-9806
  • Fax:
Mailing address:
  • Phone: 603-570-9806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number0279
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: