Organization
RISE FOR BABY AND FAMILY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN M SHEPARD (CREDENTIALING SPECIALIST)
(603) 218-2337
Entity
Organization
Contact information
Practice address
147 WASHINGTON ST, KEENE, NH 03431-3131
(603) 357-1395
(603) 357-1397
Mailing address
147 WASHINGTON ST, KEENE, NH 03431-3131
(603) 357-1395
(603) 357-1397
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
2213
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AA26947
HARVARD PILGRIM HEALTHCARE
NH
Enumeration date
02/03/2009
Last updated
04/30/2020
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