Provider Demographics
NPI:1083744148
Name:MONADNOCK FAMILY SERVICES
Entity Type:Organization
Organization Name:MONADNOCK FAMILY SERVICES
Other - Org Name:MONADNOCK ADULT CARE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:GIGI
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-283-1657
Mailing Address - Street 1:40 AVON ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-3516
Mailing Address - Country:US
Mailing Address - Phone:603-283-1657
Mailing Address - Fax:
Practice Address - Street 1:22 NORTH STREET
Practice Address - Street 2:
Practice Address - City:JAFFREY
Practice Address - State:NH
Practice Address - Zip Code:03452-5340
Practice Address - Country:US
Practice Address - Phone:603-532-2427
Practice Address - Fax:603-532-2429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251C00000X
NH261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30005894Medicaid