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General NPI Number Information
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NPI Number | 1366438491
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Entity Type | Organization
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Legal Business Name | SALEMHAVEN, INC.
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Dates
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Enumeration Date | 09/23/2005
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 23 GEREMONTY DR
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City | SALEM
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State | NH
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Zip | 03079-3314
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Country | US
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Telephone | 603-893-5586
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Fax | 603-893-4394
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Provider Business Mailing Address
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Address Line | 23 GEREMONTY DR
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City | SALEM
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State | NH
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Zip | 03079-3314
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Country | US
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Telephone | 603-893-5586
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Fax | 603-893-4394
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. RAYMOND MILLIARD
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Credential |
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Telephone | 603-893-5586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 02630
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License Number State | NH
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