Provider Demographics
NPI:1033987441
Name:SOLSTICE HOUSE
Entity Type:Organization
Organization Name:SOLSTICE HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-257-7290
Mailing Address - Street 1:101 JACKSON ST FL 4
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-2103
Mailing Address - Country:US
Mailing Address - Phone:978-459-8656
Mailing Address - Fax:978-937-2559
Practice Address - Street 1:59 MIDDLESEX AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-2533
Practice Address - Country:US
Practice Address - Phone:781-779-8392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOWELL HOUSE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility