Provider Demographics
NPI:1841290939
Name:COUNTY OF HILLSBOROUGH
Entity type:Organization
Organization Name:COUNTY OF HILLSBOROUGH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:MOOREHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:603-627-5540
Mailing Address - Street 1:400 MAST RD
Mailing Address - Street 2:
Mailing Address - City:GOFFSTOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03045-2427
Mailing Address - Country:US
Mailing Address - Phone:603-627-5540
Mailing Address - Fax:603-627-5547
Practice Address - Street 1:400 MAST RD
Practice Address - Street 2:
Practice Address - City:GOFFSTOWN
Practice Address - State:NH
Practice Address - Zip Code:03045-2427
Practice Address - Country:US
Practice Address - Phone:603-627-5540
Practice Address - Fax:603-627-5547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-29
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH00640313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH83016930Medicaid
NH83016930Medicaid