Provider Demographics
NPI:1164607032
Name:HANNAH HOUSE, INC
Entity Type:Organization
Organization Name:HANNAH HOUSE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MED COUNSELIN
Authorized Official - Phone:603-448-5339
Mailing Address - Street 1:PO BOX 591
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-0591
Mailing Address - Country:US
Mailing Address - Phone:603-448-5339
Mailing Address - Fax:603-448-5398
Practice Address - Street 1:10 ABBOTT ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1615
Practice Address - Country:US
Practice Address - Phone:603-448-5339
Practice Address - Fax:603-448-5398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30852368Medicaid
NH30007073Medicaid