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General NPI Number Information
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NPI Number | 1164607032
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Entity Type | Organization
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Legal Business Name | HANNAH HOUSE, INC
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 01/09/2008
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Provider Practice Location Address
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Address Line | 10 ABBOTT ST
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City | LEBANON
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State | NH
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Zip | 03766-1615
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Country | US
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Telephone | 603-448-5339
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Fax | 603-448-5398
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Provider Business Mailing Address
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Address Line | PO BOX 591
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City | LEBANON
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State | NH
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Zip | 03766-0591
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Country | US
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Telephone | 603-448-5339
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Fax | 603-448-5398
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. RANDY PAUL WALKER JR.
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Credential | M.ED. COUNSELIN
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Telephone | 603-448-5339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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