Healthcare Provider Details

I. General information

NPI: 1245356641
Provider Name (Legal Business Name): GIBSON CENTER FOR SENIOR SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 GROVE ST
NORTH CONWAY NH
03860-5363
US

IV. Provider business mailing address

PO BOX 655 14 GROVE STREET
NORTH CONWAY NH
03860
US

V. Phone/Fax

Practice location:
  • Phone: 603-356-3231
  • Fax:
Mailing address:
  • Phone: 603-356-3231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number5001
License Number StateNH

VIII. Authorized Official

Name: KENNETH KASLOW
Title or Position: ADMINISTRATION DIRECTOR
Credential:
Phone: 603-356-3231