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General NPI Number Information
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NPI Number | 1730852286
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Entity Type | Organization
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Legal Business Name | KEVIN GERSH
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Dates
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Enumeration Date | 07/30/2021
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Last Update Date | 12/29/2022
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Provider Practice Location Address
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Address Line | 57 REGIONAL DR STE 7
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City | CONCORD
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State | NH
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Zip | 03301-8518
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Country | US
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Telephone | 603-224-7630
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Fax | 603-410-1105
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Provider Business Mailing Address
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Address Line | 57 REGIONAL DR STE 7
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City | CONCORD
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State | NH
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Zip | 03301-8518
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Country | US
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Telephone | 603-224-7630
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Fax | 603-410-1105
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Authorized Official
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Title or Position | REGIONAL DIRECTOR OF OPERATIONS
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Name | CHRISTI HEATH
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Credential | BCBA
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Telephone | 603-387-3187
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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