Provider Demographics
NPI:1326224411
Name:NASHUA CHILDREN'S HOME
Entity Type:Organization
Organization Name:NASHUA CHILDREN'S HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLIOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-883-3851
Mailing Address - Street 1:125 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03064-2043
Mailing Address - Country:US
Mailing Address - Phone:603-883-3851
Mailing Address - Fax:603-883-5925
Practice Address - Street 1:125 AMHERST ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03064-2043
Practice Address - Country:US
Practice Address - Phone:603-883-3851
Practice Address - Fax:603-883-5925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1069251S00000X, 322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30850708Medicaid
NH30007078Medicaid