Provider Demographics
NPI:1801012562
Name:PILLSBURY HOME
Entity Type:Organization
Organization Name:PILLSBURY HOME
Other - Org Name:MILFORD HOME FOR AGED INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-672-1232
Mailing Address - Street 1:95 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055
Mailing Address - Country:US
Mailing Address - Phone:603-672-1232
Mailing Address - Fax:603-672-6108
Practice Address - Street 1:95 HIGH ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055
Practice Address - Country:US
Practice Address - Phone:603-672-1232
Practice Address - Fax:603-672-6108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH01607310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30593536Medicaid