Provider Demographics
NPI:1295857811
Name:NEW HAMPSHIRE WOMANS CHRISTIAN TEMPERANCE UNION
Entity Type:Organization
Organization Name:NEW HAMPSHIRE WOMANS CHRISTIAN TEMPERANCE UNION
Other - Org Name:BOYLSTON HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOOKKEEPER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NAIDA
Authorized Official - Middle Name:JAN
Authorized Official - Last Name:BEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-434-6936
Mailing Address - Street 1:86 MAMMOTH RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03109-4300
Mailing Address - Country:US
Mailing Address - Phone:603-622-2313
Mailing Address - Fax:603-622-5366
Practice Address - Street 1:86 MAMMOTH RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03109-4300
Practice Address - Country:US
Practice Address - Phone:603-622-2313
Practice Address - Fax:603-622-5366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1060322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children