Provider Demographics
NPI:1245356641
Name:GIBSON CENTER FOR SENIOR SERVICES, INC.
Entity type:Organization
Organization Name:GIBSON CENTER FOR SENIOR SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KASLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-356-3231
Mailing Address - Street 1:PO BOX 655
Mailing Address - Street 2:14 GROVE STREET
Mailing Address - City:NORTH CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03860
Mailing Address - Country:US
Mailing Address - Phone:603-356-3231
Mailing Address - Fax:
Practice Address - Street 1:14 GROVE ST
Practice Address - Street 2:
Practice Address - City:NORTH CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860-5363
Practice Address - Country:US
Practice Address - Phone:603-356-3231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH5001332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30591852Medicaid