Provider Demographics
NPI:1982078218
Name:WHITE HORSE ADDICTION CENTER INC.
Entity Type:Organization
Organization Name:WHITE HORSE ADDICTION CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:THISTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-651-1441
Mailing Address - Street 1:68 ROUTE 16B
Mailing Address - Street 2:P.O. BOX 487
Mailing Address - City:CENTER OSSIPEE
Mailing Address - State:NH
Mailing Address - Zip Code:03814-6850
Mailing Address - Country:US
Mailing Address - Phone:603-651-1441
Mailing Address - Fax:
Practice Address - Street 1:68 ROUTE 16B
Practice Address - Street 2:
Practice Address - City:CENTER OSSIPEE
Practice Address - State:NH
Practice Address - Zip Code:03814-6850
Practice Address - Country:US
Practice Address - Phone:603-651-1441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-24
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty