# MARANATHA MISSION HOME NETWORK, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801383807
- **Authorized official:** KRISTIN SHEPERD LADC (PRESIDENT)
- **Authorized official phone:** (802) 848-9455

## Contact information

- **Practice address:** 2580 COUNTY HIGHWAY 11, HARTWICK, NY 13348-2101
- **Practice address phone:** (802) 848-9455
- **Mailing address:** PO BOX 97, RICHFORD, VT 05476-0097

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 151.0126020 | VT | Yes |

## Other

- **Enumeration date:** 04/16/2018
- **Last updated:** 04/16/2018