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Organization

UPPER VALLEY SUPPORT GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PHILIP NORMAN ELLER M.A. (EXECUTIVE DIRECTOR)
(603) 448-6311
Entity
Organization

Contact information

Practice address
12 FLYNN ST, LEBANON, NH 03766-1311
(603) 448-6311
Mailing address
12 FLYNN ST, LEBANON, NH 03766-1311
(603) 448-6311

Taxonomy

Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
30531857
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30531857
I.D. PROVIDER NUMBER
NH
Enumeration date
03/30/2007
Last updated
08/22/2020
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