1629452339 NPI number — FAMILIES IN TRANSITION

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 1629452339 NPI number — FAMILIES IN TRANSITION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILIES IN TRANSITION
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:
Provider Other Organization Name Type Code:
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:
1629452339
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
122 MARKET ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANCHESTER
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03101-1952
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-641-9441
Provider Business Mailing Address Fax Number:
603-641-1244

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
394 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANCHESTER
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03102-4821
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-641-1143
Provider Business Practice Location Address Fax Number:
603-641-5334
Provider Enumeration Date:
07/13/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SAVARD
Authorized Official First Name:
STEPHANIE
Authorized Official Middle Name:
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
603-641-9441

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 3114415 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".




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