NPI: 1124681846
Provider Name: DARTMOUTH-HITCHCOCK CLINIC
Doing Business As: THE DOORWAY AT DARTMOUTH-HITCHCOCK LEBANON
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization
Specialization: Rehabilitation, Substance Use Disorder
CLIA Number: 30D2055125
Address:
85 MECHANIC ST STE B3-1
LEBANON, NH
ZIP 03766
Phone: (603) 653-1860
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DARTMOUTH-HITCHCOCK CLINIC is a rehabilitation and substance use disorder clinic center in Lebanon, NH. DARTMOUTH-HITCHCOCK CLINIC NPI is 1124681846. The provider is registered as an organization entity type.
The provider Is Doing Business As The Doorway At Dartmouth-hitchcock Lebanon.
The provider's business location address is:
85 MECHANIC ST STE B3-1
LEBANON, NH
ZIP 03766-537
Phone: (603) 653-1860
The provider's authorized official is Daniel P Jantzen .
The authorized official title is Cfo and has the following contact phone number (603) 650-5634.
The CLIA number assigned to this NPI record is 30D2055125 - practitioner other with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 4/18/2019 and was last updated on 4/22/2019.