Healthcare Provider Details

I. General information

NPI: 1588240576
Provider Name (Legal Business Name): FRIENDS OF LAFAYETTE HOUSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 03/22/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 LAFAYETTE RD
PORTSMOUTH NH
03801-5432
US

IV. Provider business mailing address

400 LITTLE HARBOR RD # 1104
PORTSMOUTH NH
03801-5586
US

V. Phone/Fax

Practice location:
  • Phone: 603-828-4093
  • Fax:
Mailing address:
  • Phone: 603-427-8941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. LISA PRESS
Title or Position: PRESIDENT
Credential:
Phone: 978-430-2114