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General NPI Number Information
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NPI Number | 1790248193
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Entity Type | Organization
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Legal Business Name | MT. WASHINGTON VALLEY SUPPORTS RECOVERY COALITION
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Dates
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Enumeration Date | 04/11/2019
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Last Update Date | 04/11/2019
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Provider Practice Location Address
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Address Line | 1620 EAST MAIN ST
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City | CENTER CONWAY
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State | NH
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Zip | 03813
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Country | US
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Telephone | 603-662-0668
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Fax | 603-662-0669
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Provider Business Mailing Address
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Address Line | PO BOX 202
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City | INTERVALE
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State | NH
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Zip | 03845
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Country | US
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Telephone | 603-662-0668
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Fax | 603-662-0669
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. JANICE SPINNEY
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Credential | RPH
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Telephone | 603-662-0668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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