Provider Demographics
NPI:1295224178
Name:METRO TREATMENT OF NEW HAMPSHIRE, LP
Entity Type:Organization
Organization Name:METRO TREATMENT OF NEW HAMPSHIRE, LP
Other - Org Name:NEW SEASON FRANKLIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-351-7080
Mailing Address - Street 1:2500 MAITLAND CENTER PKWY STE 250
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4174
Mailing Address - Country:US
Mailing Address - Phone:407-581-5157
Mailing Address - Fax:
Practice Address - Street 1:880 CENTRAL ST STE 10
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NH
Practice Address - Zip Code:03235-2040
Practice Address - Country:US
Practice Address - Phone:603-671-3215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METRO TREATMENT OF NEW HAMPSHIRE, LP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-06
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH041218261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone