Healthcare Provider Details

I. General information

NPI: 1215166962
Provider Name (Legal Business Name): COMMUNITY SERVICES COUNCIL OF NH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

79 SHEEP DAVIS RD
PEMBROKE NH
03275-3714
US

IV. Provider business mailing address

PO BOX 2338
CONCORD NH
03302-2338
US

V. Phone/Fax

Practice location:
  • Phone: 603-225-9694
  • Fax: 603-225-3773
Mailing address:
  • Phone: 603-225-9694
  • Fax: 603-225-3773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number03399
License Number StateNH

VIII. Authorized Official

Name: MS. SHEILA KING
Title or Position: PRESIDENT/ CEO
Credential:
Phone: 603-225-9694