Provider Demographics
NPI:1790706059
Name:CENTER FOR EATING DISORDERS MANAGEMENT INC
Entity Type:Organization
Organization Name:CENTER FOR EATING DISORDERS MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, TREASURER, SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-733-7374
Mailing Address - Street 1:360 ROUTE 101 STE 10
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-5031
Mailing Address - Country:US
Mailing Address - Phone:603-472-2846
Mailing Address - Fax:603-472-2872
Practice Address - Street 1:360 ROUTE 101 STE 10
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-5031
Practice Address - Country:US
Practice Address - Phone:603-472-2846
Practice Address - Fax:603-472-2872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH890101YM0800X
NH7201041C0700X
NH11221041C0700X
261QM0801X, 261QM0850X, 261QM0855X
NH068326-23363LF0000X
NH015394-23363LF0000X
NH057948-23363LF0000X
NH045324-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS100731634OtherMEDICARE PTAN
NH3075544Medicaid