Healthcare Provider Details

I. General information

NPI: 1083744148
Provider Name (Legal Business Name): MONADNOCK FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 NORTH STREET
JAFFREY NH
03452-5340
US

IV. Provider business mailing address

40 AVON ST
KEENE NH
03431-3516
US

V. Phone/Fax

Practice location:
  • Phone: 603-532-2427
  • Fax: 603-532-2429
Mailing address:
  • Phone: 603-283-1657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: GIGI A PRATT
Title or Position: CFO
Credential:
Phone: 603-283-1657