Provider Demographics
NPI:1063964617
Name:EHGFRANKLIN DBA THE GOLDEN CREST
Entity type:Organization
Organization Name:EHGFRANKLIN DBA THE GOLDEN CREST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUEIROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-895-3126
Mailing Address - Street 1:442 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03044-3434
Mailing Address - Country:US
Mailing Address - Phone:603-895-3126
Mailing Address - Fax:
Practice Address - Street 1:29 BALDWIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NH
Practice Address - Zip Code:03235-2000
Practice Address - Country:US
Practice Address - Phone:603-895-3126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility