Provider Demographics
NPI:1609143924
Name:GAFNEY HOME FOR THE AGED
Entity Type:Organization
Organization Name:GAFNEY HOME FOR THE AGED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:E
Authorized Official - Last Name:GOSSELIN
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:603-332-2705
Mailing Address - Street 1:90 WAKEFIELD ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-1921
Mailing Address - Country:US
Mailing Address - Phone:603-332-2705
Mailing Address - Fax:
Practice Address - Street 1:90 WAKEFIELD ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-1921
Practice Address - Country:US
Practice Address - Phone:603-332-2705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH00118251B00000X, 314000000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No251B00000XAgenciesCase Management
No347C00000XTransportation ServicesPrivate Vehicle