Provider Demographics
NPI:1013299049
Name:MYDISCOVER INCORPORATED
Entity Type:Organization
Organization Name:MYDISCOVER INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:D.
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:MA,MLADC,CAS
Authorized Official - Phone:603-702-0117
Mailing Address - Street 1:2 VILLAGE GREEN RD
Mailing Address - Street 2:B-5
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03841-5209
Mailing Address - Country:US
Mailing Address - Phone:603-702-0117
Mailing Address - Fax:603-509-2405
Practice Address - Street 1:2 VILLAGE GREEN RD
Practice Address - Street 2:B-5
Practice Address - City:HAMPSTEAD
Practice Address - State:NH
Practice Address - Zip Code:03841-5209
Practice Address - Country:US
Practice Address - Phone:603-702-0117
Practice Address - Fax:603-509-2405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH200654251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health