Organization
MALLEY FARM BOYS HOME INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK H SIPPLE (EXECUTIVE DIRECTOR)
(603) 692-5479
Entity
Organization
Contact information
Practice address
250 INDIGO HILL RD, SOMERSWORTH, NH 03878-2917
(603) 692-5479
(603) 692-5956
Mailing address
250 INDIGO HILL RD, SOMERSWORTH, NH 03878-2917
(603) 692-5479
(603) 692-5956
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
1077
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30007100
—
NH
05
—
30830125
—
NH
Enumeration date
05/07/2007
Last updated
08/22/2020
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