Provider Demographics
NPI:1770027286
Name:AWARE RECOVERY CARE INC
Entity Type:Organization
Organization Name:AWARE RECOVERY CARE INC
Other - Org Name:AWARE RECOVERY CARE OF NEW HAMPSHIRE LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT, OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:EACOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-779-5799
Mailing Address - Street 1:556 WASHINGTON AVE
Mailing Address - Street 2:UNIT 201
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-1149
Mailing Address - Country:US
Mailing Address - Phone:860-899-6685
Mailing Address - Fax:
Practice Address - Street 1:15 CONSTITUTION DR
Practice Address - Street 2:SUITE 2N
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6042
Practice Address - Country:US
Practice Address - Phone:203-779-5799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty