Provider Demographics
NPI:1619759982
Name:HOPEVILLE MENTAL HEALTH, LLC
Entity Type:Organization
Organization Name:HOPEVILLE MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FARNWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:203-613-6454
Mailing Address - Street 1:10 TECHNOLOGY WAY STE 3W7G
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3245
Mailing Address - Country:US
Mailing Address - Phone:508-709-5554
Mailing Address - Fax:603-948-4954
Practice Address - Street 1:10 TECHNOLOGY WAY STE 3W7G
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3245
Practice Address - Country:US
Practice Address - Phone:508-709-5554
Practice Address - Fax:603-948-4954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty