Organization
BONFIRE BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM BROWN (DIRECTOR OF COMPLIANCE)
(870) 243-7219
Entity
Organization
Contact information
Practice address
35 INDUSTRIAL WAY STE 11E, ROCHESTER, NH 03867-6202
(603) 617-4815
Mailing address
10461 MILL RUN CIR STE 810, OWINGS MILLS, MD 21117-5549
(410) 807-8471
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3103840
—
NH
05
—
3127880
—
NH
Enumeration date
04/27/2015
Last updated
01/12/2024
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