Healthcare Provider Details

I. General information

NPI: 1477739175
Provider Name (Legal Business Name): SPAULDING ACADEMY & FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 01/29/2021
Certification Date: 01/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 SPAULDING RD
NORTHFIELD NH
03276-4608
US

IV. Provider business mailing address

72 SPAULDING RD
NORTHFIELD NH
03276-4608
US

V. Phone/Fax

Practice location:
  • Phone: 603-286-8901
  • Fax: 603-286-8650
Mailing address:
  • Phone: 603-286-8901
  • Fax: 603-286-8650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. AMANDA CHAMPAGNE
Title or Position: EXE. DIRECTOR OF FAMILY SERVICES
Credential: MS, MBA
Phone: 603-286-8901