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Organization

SALEMHAVEN, INC.

Active
Other names
Salemhaven Nursing Home
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RAYMOND MILLIARD (ADMINISTRATOR)
(603) 893-5586
Entity
Organization

Contact information

Practice address
23 GEREMONTY DR, SALEM, NH 03079-3314
(603) 893-5586
(603) 893-4394
Mailing address
23 GEREMONTY DR, SALEM, NH 03079-3314
(603) 893-5586
(603) 893-4394

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
02630
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
305058
ANTHEM BC/BS PROV NUMBER
NH
05
99305036
NH
01
Z46637901
BC/BS OF MA PROVIDER #
MA
Enumeration date
09/23/2005
Last updated
01/12/2012
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