Provider Demographics
NPI:1902012123
Name:METRO TREATMENT OF NEW HAMPSHIRE, LP
Entity Type:Organization
Organization Name:METRO TREATMENT OF NEW HAMPSHIRE, LP
Other - Org Name:MANCHESTER METRO TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-351-7080
Mailing Address - Street 1:2500 MAITLAND CENTER PARKWAY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4174
Mailing Address - Country:US
Mailing Address - Phone:407-351-7080
Mailing Address - Fax:407-351-6930
Practice Address - Street 1:228 MAPLE ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03303-5500
Practice Address - Country:US
Practice Address - Phone:603-622-5005
Practice Address - Fax:603-622-5051
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METRO TREATMENT OF NEW HAMPSHIRE, LP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH200607251S00000X
261QM2800X
NH60063336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No251S00000XAgenciesCommunity/Behavioral Health
No3336C0002XSuppliersPharmacyClinic Pharmacy