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NPI Code Detail

MEDICARE: MANCHESTER ALCOHOLISM REHABILITATION CENTER

MEDICARE: MANCHESTER ALCOHOLISM REHABILITATION CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
2101YA0400XAddiction (Substance Use Disorder) Counselor
3324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1720151830
Entity Type Code : Organization
Provider Name (Legal Business Name) : MANCHESTER ALCOHOLISM REHABILITATION CENTER
Provider Business Mailing Address
First Line : PO BOX 4982
Second Line :
City : MANCHESTER
State : NH
Zip : 03108-4982
Country : US
Telephone Number : 603-622-3020
Fax Number :
Provider Business Practice Location Address
First Line : 140 QUEEN CITY AVE
Second Line :
City : MANCHESTER
State : NH
Zip : 03103-7122
Country : US
Telephone Number : 603-622-3020
Fax Number :
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : CATHERINE KUHN
Credential :
Telephone Number : 603-623-8863
Provider Enumeration Date : 11/16/2006
Last Update Date : 09/15/2025

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Directions to “MANCHESTER ALCOHOLISM REHABILITATION CENTER ” Practice Location

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