Healthcare Provider Details

I. General information

NPI: 1063346807
Provider Name (Legal Business Name): NASHUA SOUP KITCHEN AND SHELTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 QUINCY ST
NASHUA NH
03060-3417
US

IV. Provider business mailing address

PO BOX 3116
NASHUA NH
03061-3116
US

V. Phone/Fax

Practice location:
  • Phone: 603-889-7770
  • Fax:
Mailing address:
  • Phone: 603-889-7770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: JANE GOODMAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 603-889-7770