MANCHESTER YOUTH ALLIANCE, LLC (NPI# 1386265023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386265023 |
| Entity Type | Organization |
| Organization Name | MANCHESTER YOUTH ALLIANCE, LLC |
| Practice Address |
1056 River Rd Manchester NH 03104-1958 |
| Mailing Address |
Po Box 325 Orford NH 03777-0325 |
| Practice Telephone | 6033539102 |
| Practice Fax Number | 6033539412 |
| Mailing Telephone | 6033539102 |
| Mailing Fax Number | 6033539412 |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2020-05-05 |
| Authorized Official Name | JEFF PARK (MANAGER) |
| Authorized Official Telephone | 6032542808 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Street Address |
1056 RIVER RD |
| City | MANCHESTER |
| State | NH |
| Zip Code | 03104-1958 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104254424 | Christina Loder | Counselor | 1056 River Rd, Manchester, NH 03104-1958 | 2013-10-23 |
| 1174085930 | Lorene Theresa Zammuto | Registered Nurse | 1056 River Rd, Manchester, NH 03104-1958 | 2019-04-02 |
| 1356818769 | Granite Pathways, Inc. | Community/Behavioral Health | 1056 River Rd, Manchester, NH 03104-1958 | 2018-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730675562 | Hannah E Boutselis | Nurse Practitioner | 1750 Elm St., Suite 201a, Manchester, NH 03104 | 2018-07-04 |
| 1366948770 | Families In Transition | Counselor | 15 Brook St, Manchester, NH 03104 | 2018-04-04 |
| 1528586872 | Nicole Mitchell | Physical Therapy Assistant | 235 Myrtle St., Manchester, NH 03104 | 2017-09-07 |
| 1851819270 | Community House Calls LLC | Contractor | 497 Hooksett Road, 232, Manchester, NH 03104 | 2017-09-06 |
| 1407207533 | Brianna Cassidy | Specialist/Technologist | 62 Jonathan Ln, Manchester, NH 03104 | 2016-06-30 |
| 1477926871 | Anthony Macri | Skilled Nursing Facility | 524 Blevens Dr., Manchester, NH 03104 | 2015-11-06 |
| 1225412935 | Families In Transition | Counselor | 136 Lowell St, Manchester, NH 03104 | 2015-07-13 |
| 1386036622 | Phoenix Rising Counseling Services, LLC | Counselor | 114 Bay Street, Suite A, Manchester, NH 03104 | 2015-02-24 |
| 1366795767 | Alicia M. Kleczkowski | Nurse Practitioner | 57 Webster St., Manchester, NH 03104 | 2012-10-23 |
| 1356615710 | Laurie Lagasse | Physical Therapy Assistant | 44 West Webster St, Manchester, NH 03104 | 2012-03-02 |
| Find all providers in zip 03104 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295857811 | New Hampshire Womans Christian Temperance Union | Residential Treatment Facility, Emotionally Disturbed Children | 86 Mammoth Rd, Manchester, NH 03109-4300 | 2007-04-04 |
| 1851621247 | New Hope Manor | Residential Treatment Facility, Emotionally Disturbed Children | 48 Hartford Rd, Manchester, CT 06040-5921 | 2010-01-06 |
| 1386766624 | Webster House | Residential Treatment Facility, Emotionally Disturbed Children | 135 Webster St, Manchester, NH 03104-2511 | 2007-04-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043538523 | The Hartmann School | Residential Treatment Facility, Emotionally Disturbed Children | 768 Doetown Road, Rumney, NH 03266 | 2010-05-10 |
| 1235368218 | Spaulding Youth Center, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 130 Shedd Road, Northfield, NH 03276 | 2009-07-10 |
| 1720265531 | New England Salem Children's Trust | Residential Treatment Facility, Emotionally Disturbed Children | 768 Doetown Rd., Rumney, NH 03266 | 2008-01-23 |
| 1699951541 | Rolfe and Rumford Home | Residential Treatment Facility, Emotionally Disturbed Children | 23 Rundlett St, Concord, NH 03301-2223 | 2008-01-10 |
| 1396920344 | The Chase Home for Children | Residential Treatment Facility, Emotionally Disturbed Children | 698 Middle Rd, Portsmouth, NH 03801-4829 | 2008-01-08 |
| 1184812463 | Wediko Children's Services | Residential Treatment Facility, Emotionally Disturbed Children | 11 Bobcat Blvd, Windsor, NH 03244-7419 | 2007-10-11 |
| 1295936656 | Odyssey House, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 124 Landing Rd, Hampton, NH 03842-2603 | 2007-05-31 |
| 1295936730 | Odyssey House, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 30 Winnacunnet Rd, Hampton, NH 03842-2121 | 2007-05-31 |
| 1376756528 | Malley Farm Boys Home Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 250 Indigo Hill Rd, Somersworth, NH 03878-2917 | 2007-05-07 |
| 1215159694 | Tobey School | Residential Treatment Facility, Emotionally Disturbed Children | 45 S Fruit St, Concord, NH 03301-2410 | 2007-05-03 |
| Find all providers with the same taxonomy | ||||
| City | MANCHESTER |
| Zip Code | 03104 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.