Healthcare Provider Details

I. General information

NPI: 1700298304
Provider Name (Legal Business Name): MAINTAINING INDEPENDENCE ADULT DAY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2014
Last Update Date: 05/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 KIMBALL DR UNIT 110
HOOKSETT NH
03106-2603
US

IV. Provider business mailing address

11 KIMBALL DR UNIT 110
HOOKSETT NH
03106-2603
US

V. Phone/Fax

Practice location:
  • Phone: 603-568-9237
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KYLE WORTH
Title or Position: OWNER
Credential:
Phone: 603-568-9237