| Maranatha Mission Home Network, Inc | |
|
2580 County Highway 11 Hartwick NY 13348-2101 | |
| (802) 848-9455 | |
| Not Available |
| Full Name | Maranatha Mission Home Network, Inc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2580 County Highway 11, Hartwick, New York |
| Authorized Official Name and Position | Kristin Sheperd (PRESIDENT) |
| Authorized Official Contact | 8028489455 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maranatha Mission Home Network, Inc Po Box 97 Richford VT 05476-0097 Ph: () - | Maranatha Mission Home Network, Inc 2580 County Highway 11 Hartwick NY 13348-2101 Ph: (802) 848-9455 |
| NPI Number | 1801383807 |
|---|---|
| Provider Enumeration Date | 04/16/2018 |
| Last Update Date | 04/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801383807 | NPI | - | NPPES |
| 14143916 | Other | VT | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 151.0126020 (Vermont) | Primary |
Jody Kenyon, Lcsw-r Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3019 County Highway 11 Suite 3, Hartwick, NY 13348 Phone: 160-737-8979 |