Healthcare Provider Details

I. General information

NPI: 1003914466
Provider Name (Legal Business Name): MENTAL HEALTH CENTER FOR SOUTHERN NEW HAMPSHIRE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 TSIENNETO RD
DERRY NH
03038
US

IV. Provider business mailing address

10 TSIENNETO RD
DERRY NH
03038-1505
US

V. Phone/Fax

Practice location:
  • Phone: 603-434-1577
  • Fax: 603-434-3101
Mailing address:
  • Phone: 603-434-1577
  • Fax: 603-434-3101

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 StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: VIC TOPO
Title or Position: CEO
Credential:
Phone: 603-434-1577