# MOUNT PROSPECT ACADEMY, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720281264
- **Authorized official:** JAY T WOLTER (PRESIDENT)
- **Authorized official phone:** (603) 353-9102

## Contact information

- **Practice address:** 350 MAIN ST, PLYMOUTH, NH 03264-4518
- **Practice address phone:** (603) 536-1102
- **Practice address fax:** (603) 536-3074
- **Mailing address:** PO BOX 325, ORFORD, NH 03777-0325
- **Mailing address phone:** (603) 353-9102
- **Mailing address fax:** (603) 353-9412

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | — | — |
| 253Z00000X | In Home Supportive Care Agency | — | — | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |
| 323P00000X | Psychiatric Residential Treatment Facility | — | — | — |

## Other

- **Enumeration date:** 06/11/2007
- **Last updated:** 08/20/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 30832240 | — | NH |
| 05 | — | 30854897 | — | NH |