Healthcare Provider Details

I. General information

NPI: 1225910912
Provider Name (Legal Business Name): SOS RECOVERY COMMUNITY ORGANIZATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 SIGNAL ST
ROCHESTER NH
03867-2729
US

IV. Provider business mailing address

14 SIGNAL ST
ROCHESTER NH
03867-2729
US

V. Phone/Fax

Practice location:
  • Phone: 603-841-2350
  • Fax: 603-516-2761
Mailing address:
  • Phone: 603-841-2350
  • Fax: 603-516-2761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOHN BURNS
Title or Position: EXECUTIVE DIRECTOR
Credential: CRSW
Phone: 603-841-2350