| White Birch Recovery Services, Pllc | |
|
2 Washington St Suite 216 Dover NH 03820-3890 | |
| (603) 235-1489 | |
| (603) 200-3035 |
| Full Name | White Birch Recovery Services, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 2 Washington St, Dover, New Hampshire |
| Authorized Official Name and Position | John Eldredge (OWNER) |
| Authorized Official Contact | 6032351489 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| White Birch Recovery Services, Pllc 2 Washington St Suite 216 Dover NH 03820-3890 Ph: (603) 235-1489 | White Birch Recovery Services, Pllc 2 Washington St Suite 216 Dover NH 03820-3890 Ph: (603) 235-1489 |
| NPI Number | 1548797228 |
|---|---|
| Provider Enumeration Date | 05/12/2017 |
| Last Update Date | 05/12/2017 |
| Medicare PECOS PAC ID | 4385007129 |
|---|---|
| Medicare Enrollment ID | O20230828002166 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548797228 | NPI | - | NPPES |
| 3103880 | Medicaid | NH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 0981 (New Hampshire) | Primary |
| Provider Name | John Charles Eldredge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194179895 PECOS PAC ID: 6103289947 Enrollment ID: I20230828002267 |
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