Organization
INTO ACTION RECOVERY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN GERSON (MEMBER)
(781) 248-3360
Entity
Organization
Contact information
Practice address
273 DUBUQUE ST, MANCHESTER, NH 03102-3706
(781) 248-3360
Mailing address
273 DUBUQUE ST, MANCHESTER, NH 03102-3706
(781) 248-3360
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
03/21/2023
Last updated
03/21/2023
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