Healthcare Provider Details

I. General information

NPI: 1265353528
Provider Name (Legal Business Name): THE FAMILY RESOURCE CENTER AT GORHAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 MAIN ST
BERLIN NH
03570-2400
US

IV. Provider business mailing address

164 MAIN ST
BERLIN NH
03570-2477
US

V. Phone/Fax

Practice location:
  • Phone: 603-466-5190
  • Fax: 603-466-9022
Mailing address:
  • Phone: 603-466-5190
  • Fax: 603-466-9022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: NATHAN MORIN
Title or Position: HR MANAGER
Credential:
Phone: 603-466-5190