Healthcare Provider Details

I. General information

NPI: 1841290939
Provider Name (Legal Business Name): COUNTY OF HILLSBOROUGH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 12/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 MAST RD
GOFFSTOWN NH
03045-2427
US

IV. Provider business mailing address

400 MAST RD
GOFFSTOWN NH
03045-2427
US

V. Phone/Fax

Practice location:
  • Phone: 603-627-5540
  • Fax: 603-627-5547
Mailing address:
  • Phone: 603-627-5540
  • Fax: 603-627-5547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number00640
License Number StateNH

VIII. Authorized Official

Name: MR. BRUCE C MOOREHEAD
Title or Position: ADMINISTRATOR
Credential: NHA
Phone: 603-627-5540