Provider Demographics
NPI:1790248193
Name:MT. WASHINGTON VALLEY SUPPORTS RECOVERY COALITION
Entity Type:Organization
Organization Name:MT. WASHINGTON VALLEY SUPPORTS RECOVERY COALITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:603-662-0668
Mailing Address - Street 1:PO BOX 202
Mailing Address - Street 2:
Mailing Address - City:INTERVALE
Mailing Address - State:NH
Mailing Address - Zip Code:03845
Mailing Address - Country:US
Mailing Address - Phone:603-662-0668
Mailing Address - Fax:603-662-0669
Practice Address - Street 1:1620 EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTER CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03813
Practice Address - Country:US
Practice Address - Phone:603-662-0668
Practice Address - Fax:603-662-0669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health