Provider Demographics
NPI:1376889212
Name:MOVING FORWARD HEALTHCARE FOR OLDER ADULTS LLC
Entity Type:Organization
Organization Name:MOVING FORWARD HEALTHCARE FOR OLDER ADULTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:A
Authorized Official - Last Name:DORSON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:603-680-1089
Mailing Address - Street 1:2 BIRCH RD
Mailing Address - Street 2:
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458-1903
Mailing Address - Country:US
Mailing Address - Phone:603-680-1089
Mailing Address - Fax:603-784-5152
Practice Address - Street 1:2 BIRCH RD
Practice Address - Street 2:
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-1903
Practice Address - Country:US
Practice Address - Phone:603-680-1089
Practice Address - Fax:603-784-5152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-21
Last Update Date:2012-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH031437-23363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty