Provider Demographics
NPI:1417133281
Name:ANNIE E CASEY FOUNDATION
Entity Type:Organization
Organization Name:ANNIE E CASEY FOUNDATION
Other - Org Name:CASEY FAMILY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SYMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-224-8909
Mailing Address - Street 1:105 LOUDON RD
Mailing Address - Street 2:BUILDING #2
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5601
Mailing Address - Country:US
Mailing Address - Phone:603-224-8909
Mailing Address - Fax:603-224-2584
Practice Address - Street 1:105 LOUDON RD
Practice Address - Street 2:BUILDING #2
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5601
Practice Address - Country:US
Practice Address - Phone:603-224-8909
Practice Address - Fax:603-224-2584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30851653Medicaid