Provider Demographics
NPI:1467833103
Name:THE PROCESS RECOVERY CENTER, LLC
Entity type:Organization
Organization Name:THE PROCESS RECOVERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ETLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-389-5579
Mailing Address - Street 1:41 SAGAMORE PARK RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NH
Mailing Address - Zip Code:03051-4915
Mailing Address - Country:US
Mailing Address - Phone:603-402-3810
Mailing Address - Fax:
Practice Address - Street 1:41 SAGAMORE PARK RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NH
Practice Address - Zip Code:03051-4915
Practice Address - Country:US
Practice Address - Phone:603-402-3810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility