Organization
ELLIOT PROFESSIONAL SERVICES
Active
Organization
ELLIOT PROFESSIONAL SERVICES
Active
Parent organization
ELLIOT PROFESSIONAL SERVICES
Other names
Elliot Behavioral Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELLIOT PROFESSIONAL SERVICES
Authorized official
RICHARD P. HERMAN (DIRECTOR OF OPERATIONS & FINANCE)
(603) 663-4904
Entity
Organization
Contact information
Practice address
445 CYPRESS ST STE 8, ELLIOT BEHAVIORAL HEALTH SERVICES, MANCHESTER, NH 03103-3600
(603) 668-4079
(603) 663-8605
Mailing address
445 CYPRESS ST STE 8, ELLIOT BEHAVIORAL HEALTH SERVICES, MANCHESTER, NH 03103-3600
(603) 668-4079
(603) 663-8605
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30212259
—
NH
01
—
CK3360
RR MEDICARE GRP PIN
NH
Enumeration date
03/21/2006
Last updated
06/20/2008
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