Provider Demographics
NPI:1255946752
Name:SEASIDE SERENITY ADDICTION SUPPORT & REFERRAL
Entity type:Organization
Organization Name:SEASIDE SERENITY ADDICTION SUPPORT & REFERRAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:TENBROECK-BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:CRSW
Authorized Official - Phone:603-918-1858
Mailing Address - Street 1:6 APPLEDORE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03862-2303
Mailing Address - Country:US
Mailing Address - Phone:603-380-0662
Mailing Address - Fax:
Practice Address - Street 1:6 APPLEDORE AVE
Practice Address - Street 2:
Practice Address - City:NORTH HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03862-2303
Practice Address - Country:US
Practice Address - Phone:603-380-0662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty