Provider Demographics
NPI:1558548933
Name:ORION HOUSE, INC
Entity Type:Organization
Organization Name:ORION HOUSE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:S
Authorized Official - Last Name:GALLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-863-9605
Mailing Address - Street 1:139 ELM ST
Mailing Address - Street 2:PO BOX 25
Mailing Address - City:NEWPORT
Mailing Address - State:NH
Mailing Address - Zip Code:03773-2109
Mailing Address - Country:US
Mailing Address - Phone:603-863-9605
Mailing Address - Fax:603-863-0750
Practice Address - Street 1:139 ELM ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:NH
Practice Address - Zip Code:03773-2109
Practice Address - Country:US
Practice Address - Phone:603-863-9605
Practice Address - Fax:603-863-0750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH322D00000X320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH322D00000XMedicaid