Provider Demographics
NPI:1114460284
Name:AWARE RECOVERY CARE OF NEW HAMPSHIRE, LLC
Entity Type:Organization
Organization Name:AWARE RECOVERY CARE OF NEW HAMPSHIRE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT, OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:EACOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-779-5799
Mailing Address - Street 1:556 WASHINGTON AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-1149
Mailing Address - Country:US
Mailing Address - Phone:203-779-5799
Mailing Address - Fax:203-421-6830
Practice Address - Street 1:15 CONSTITUTION DR
Practice Address - Street 2:UNIT 2N
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6042
Practice Address - Country:US
Practice Address - Phone:203-779-5799
Practice Address - Fax:203-421-6830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty