Provider Demographics
NPI:1104694694
Name:MERRIMACK ADULT DAY HEALTH CENTER LLC
Entity type:Organization
Organization Name:MERRIMACK ADULT DAY HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/ PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KERENSARAI
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-521-5984
Mailing Address - Street 1:32 DANIEL WEBSTER HWY
Mailing Address - Street 2:UNIT 10
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054
Mailing Address - Country:US
Mailing Address - Phone:603-521-5984
Mailing Address - Fax:
Practice Address - Street 1:32 DANIEL WEBSTER HWY
Practice Address - Street 2:UNIT 10
Practice Address - City:MERRIMACK
Practice Address - State:NH
Practice Address - Zip Code:03054
Practice Address - Country:US
Practice Address - Phone:603-521-5984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-14
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care