Provider Demographics
NPI:1003000365
Name:NASHUA YOUTH COUNCIL INC
Entity Type:Organization
Organization Name:NASHUA YOUTH COUNCIL INC
Other - Org Name:THE YOUTH COUNCIL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-889-1090
Mailing Address - Street 1:74 NORTHEASTERN BLVD STE 10A
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-3142
Mailing Address - Country:US
Mailing Address - Phone:603-889-1090
Mailing Address - Fax:603-598-1703
Practice Address - Street 1:74 NORTHEASTERN BLVD STE 10A
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-3142
Practice Address - Country:US
Practice Address - Phone:603-889-1090
Practice Address - Fax:603-598-1703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
788015050NHOtherANTHEM