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NPI Code Detail

MEDICARE: SELF-EMPOWERMENT-NH LLC

MEDICARE: SELF-EMPOWERMENT-NH LLC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor0683NH

General Provider Information

NPI Number : 1952703647
Entity Type Code : Organization
Provider Name (Legal Business Name) : SELF-EMPOWERMENT-NH LLC
Provider Business Mailing Address
First Line : 85 WARREN ST
Second Line :
City : CONCORD
State : NH
Zip : 03301-3837
Country : US
Telephone Number : 603-470-6937
Fax Number : 603-856-8240
Provider Business Practice Location Address
First Line : 85 WARREN ST
Second Line :
City : CONCORD
State : NH
Zip : 03301-3837
Country : US
Telephone Number : 603-470-6937
Fax Number : 603-856-8240
Authorized Official
Title or Position : SUBSTANCE ABUSE COUNSELOR
Name : MRS. LORI LEE MAGOON
Credential : MLADC
Telephone Number : 603-470-6937
Provider Enumeration Date : 09/24/2014
Last Update Date : 09/24/2014

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Directions to “SELF-EMPOWERMENT-NH LLC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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