Organization
HAWTHORN RECOVERY CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA MENNETO (BUSINESS MANAGER)
(802) 379-5821
Entity
Organization
Contact information
Practice address
160 BENMONT AVE, SUITE 31, BENNINGTON, VT 05201-1873
(802) 579-7980
Mailing address
160 BENMONT AVE, SUITE 31, BENNINGTON, VT 05201-1873
(802) 579-7980
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
207Q00000X
Family Medicine Physician
—
—
2084P0802X
Addiction Psychiatry Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
06/12/2014
Last updated
07/17/2014
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