Healthcare Provider Details

I. General information

NPI: 1669658092
Provider Name (Legal Business Name): THE FAMILY RESOURCE CENTER AT GORHAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2008
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 MAIN ST
BERLIN NH
03570-2477
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 TaxonomyN
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GABRIELLE FLANDERS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 603-466-5190