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General NPI Number Information
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NPI Number | 1255946752
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Entity Type | Organization
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Legal Business Name | SEASIDE SERENITY ADDICTION SUPPORT & REFERRAL
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Dates
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Enumeration Date | 09/11/2020
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Last Update Date | 09/11/2020
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Provider Practice Location Address
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Address Line | 6 APPLEDORE AVE
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City | NORTH HAMPTON
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State | NH
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Zip | 03862-2303
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Country | US
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Telephone | 603-380-0662
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Fax |
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Provider Business Mailing Address
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Address Line | 6 APPLEDORE AVE
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City | NORTH HAMPTON
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State | NH
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Zip | 03862-2303
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Country | US
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Telephone | 603-380-0662
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. LINDA LEE TENBROECK-BROWN
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Credential | CRSW
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Telephone | 603-918-1858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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