Healthcare Provider Details

I. General information

NPI: 1275672057
Provider Name (Legal Business Name): MONADNOCK DEVELOPMENTAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 RAILROAD ST
KEENE NH
03431-3747
US

IV. Provider business mailing address

121 RAILROAD ST
KEENE NH
03431-3747
US

V. Phone/Fax

Practice location:
  • Phone: 603-352-1304
  • Fax: 603-352-1637
Mailing address:
  • Phone: 603-352-1304
  • Fax: 603-352-1637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. ALAN GREENE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 603-352-1304