Healthcare Provider Details

I. General information

NPI: 1104694694
Provider Name (Legal Business Name): MERRIMACK ADULT DAY HEALTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2023
Last Update Date: 12/21/2023
Certification Date: 12/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 DANIEL WEBSTER HWY UNIT 10
MERRIMACK NH
03054
US

IV. Provider business mailing address

32 DANIEL WEBSTER HWY UNIT 10
MERRIMACK NH
03054
US

V. Phone/Fax

Practice location:
  • Phone: 603-521-5984
  • Fax:
Mailing address:
  • Phone: 603-521-5984
  • 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: MRS. KERENSARAI REYES
Title or Position: ADMINISTRATOR/ PROGRAM DIRECTOR
Credential:
Phone: 603-521-5984