Provider Demographics
NPI:1144217258
Name:MERRIMACK ASSISTED LIVING SYSTEMS
Entity Type:Organization
Organization Name:MERRIMACK ASSISTED LIVING SYSTEMS
Other - Org Name:ARBORS OF BEDFORD ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-420-1500
Mailing Address - Street 1:70 HAWTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6912
Mailing Address - Country:US
Mailing Address - Phone:603-647-9300
Mailing Address - Fax:603-621-4190
Practice Address - Street 1:70 HAWTHORNE DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6912
Practice Address - Country:US
Practice Address - Phone:603-647-9300
Practice Address - Fax:603-621-4190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-04
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02606310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30593099Medicaid