Provider Demographics
NPI:1255114708
Name:MOUNTAIN VIEW RETREAT, LLC
Entity type:Organization
Organization Name:MOUNTAIN VIEW RETREAT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EVA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC, MLADC
Authorized Official - Phone:603-213-0882
Mailing Address - Street 1:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:FITZWILLIAM
Mailing Address - State:NH
Mailing Address - Zip Code:03447-0432
Mailing Address - Country:US
Mailing Address - Phone:603-912-7607
Mailing Address - Fax:603-379-1661
Practice Address - Street 1:143 JAFFREY RD
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03455-2517
Practice Address - Country:US
Practice Address - Phone:603-213-0882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-17
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder