Healthcare Provider Details

I. General information

NPI: 1821266578
Provider Name (Legal Business Name): COMMUNITY ACTION PROGRAM BELKNAP-MERRIMACK COUNTIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 01/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 BELMONT RD
LACONIA NH
03246-3725
US

IV. Provider business mailing address

PO BOX 1016
CONCORD NH
03302-1016
US

V. Phone/Fax

Practice location:
  • Phone: 603-524-5453
  • Fax: 603-528-2795
Mailing address:
  • Phone: 603-225-3295
  • Fax: 603-228-1898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. RALPH LITTLEFIELD
Title or Position: EXECUTIVE DIRECTOR
Credential: B.A.
Phone: 603-225-3295