Provider Demographics
NPI:1275173627
Name:PLYMOUTH AREA RECOVERY CONNECTION
Entity Type:Organization
Organization Name:PLYMOUTH AREA RECOVERY CONNECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DYLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-481-1041
Mailing Address - Street 1:258 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264-3612
Mailing Address - Country:US
Mailing Address - Phone:603-481-1041
Mailing Address - Fax:
Practice Address - Street 1:258 HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-3612
Practice Address - Country:US
Practice Address - Phone:603-481-1041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care