Organization
REVIVE RECOVERY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA KEARNS (CREDENTIALING SPECIALIST)
(603) 882-3616
Entity
Organization
Contact information
Practice address
263 MAIN ST, NASHUA, NH 03060-2936
(603) 793-2884
Mailing address
77 NORTHEASTERN BLVD STE C, NASHUA, NH 03062-3128
(603) 882-3616
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
—
—
261QR0800X
Recovery Care Clinic/Center
Primary
—
—
Other
Enumeration date
09/07/2017
Last updated
09/07/2017
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