1518367002 NPI number — STRAFFORD COUNTY COMMUNITY ACTION COMMITTEE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518367002 NPI number — STRAFFORD COUNTY COMMUNITY ACTION COMMITTEE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STRAFFORD COUNTY COMMUNITY ACTION COMMITTEE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COMMUNITY ACTION PARTNERSHIP OF STRAFFORD COUNTY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518367002
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/03/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 160
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DOVER
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03821-0160
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-516-8192
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
642 CENTRAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOVER
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03820-3414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-516-8192
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/03/2014

Additional Information

Authorized Official

Authorized Official Last Name:
ADAMS
Authorized Official First Name:
MELISSA
Authorized Official Middle Name:
Authorized Official Title or Position:
DEPUTY DIRECTOR
Authorized Official Telephone Number:
603-516-8192

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3086011 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".




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