Basic Information
Provider Information
NPI: 1992987051
EntityType: 2
ReplacementNPI:  
OrganizationName: COMMUNITY COUNCIL OF NASHUA NH
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 7 PROSPECT ST
Address2:  
City: NASHUA
State: NH
PostalCode: 030603921
CountryCode: US
TelephoneNumber: 6038896147
FaxNumber:  
Practice Location
Address1: 15 PROSPECT ST
Address2:  
City: NASHUA
State: NH
PostalCode: 030603923
CountryCode: US
TelephoneNumber: 6038896147
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/30/2007
LastUpdateDate: 11/30/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HANKS
AuthorizedOfficialFirstName: ROBIN
AuthorizedOfficialMiddleName: A
AuthorizedOfficialTitleorPosition: ADMISSION COLLECTION MGR
AuthorizedOfficialTelephone: 6038896147
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000X  Y AgenciesCommunity/Behavioral Health 

No ID Information.


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