Provider Demographics
NPI:1538602701
Name:NEW ENGLAND RECOVERY AND WELLNESS LLC
Entity type:Organization
Organization Name:NEW ENGLAND RECOVERY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GAGNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-438-3276
Mailing Address - Street 1:81 HALL ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-3488
Mailing Address - Country:US
Mailing Address - Phone:603-556-8144
Mailing Address - Fax:772-873-9997
Practice Address - Street 1:81 HALL ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3488
Practice Address - Country:US
Practice Address - Phone:772-285-6611
Practice Address - Fax:772-873-9997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility