Provider Demographics
NPI:1376088724
Name:SOBRIETY CENTERS OF NEW HAMPSHIRE
Entity Type:Organization
Organization Name:SOBRIETY CENTERS OF NEW HAMPSHIRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-913-4683
Mailing Address - Street 1:55 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANTRIM
Mailing Address - State:NH
Mailing Address - Zip Code:03440
Mailing Address - Country:US
Mailing Address - Phone:603-280-4380
Mailing Address - Fax:
Practice Address - Street 1:55 MAIN STREET
Practice Address - Street 2:
Practice Address - City:ANTRIM
Practice Address - State:NH
Practice Address - Zip Code:03440
Practice Address - Country:US
Practice Address - Phone:603-365-8335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-21
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QR0405X
NH04192324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3107782Medicaid