MANCHESTER YOUTH ALLIANCE, LLC NPI 1386265023

Residential Treatment Facility, Emotionally Disturbed Children in Manchester, NH

NPI 1386265023 Organization Residential Treatment Facility, Emotiona...

About MANCHESTER YOUTH ALLIANCE, LLC

Manchester Youth Alliance, Llc is a provider established in Manchester, New Hampshire specializing in residential treatment facility, emotionally disturbed children. The NPI number of Manchester Youth Alliance, Llc is 1386265023 and was assigned on May 2020. The practitioner's primary taxonomy code is 322D00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Jeff Park (Manager)

NPI

1386265023

Provider NameMANCHESTER YOUTH ALLIANCE, LLC
Provider Location Address1056 RIVER RD MANCHESTER, NH 03104
Provider Mailing AddressPO BOX 325 ORFORD, NH 03777
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date05-05-2020
Last Update Date05-05-2020


Primary Taxonomy

Taxonomy Code322D00000X
ClassificationResidential Treatment Facility, Emotionally Disturbed Children
TypeResidential Treatment Facilities
Taxonomy DescriptionA residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

Business Address

MANCHESTER YOUTH ALLIANCE, LLC
1056 RIVER RD
MANCHESTER, NH
ZIP 03104
Phone: (603) 353-9102
Fax: (603) 353-9412

Get Directions


Mailing Address

MANCHESTER YOUTH ALLIANCE, LLC
PO BOX 325
ORFORD, NH
ZIP 03777
Phone: (603) 353-9102
Fax: (603) 353-9412



Authorized Official

Authorized Official Name JEFF PARK
Authorized Official TitleMANAGER
Authorized Official Phone(603) 254-2808

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1174085930 LORENE THERESA ZAMMUTO
Individual
Registered Nurse (Administrator)1056 RIVER RD
MANCHESTER, NH 03104
(603) 931-3901
1104254424MRS. CHRISTINA LODER LCMHC
Individual
Counselor (Mental Health)1056 RIVER RD
MANCHESTER, NH 03104
(603) 931-3914
1356818769GRANITE PATHWAYS, INC.
Organization
Substance Abuse Rehabilitation Facility (Substance Abuse Treatment, Children)1056 RIVER RD
MANCHESTER, NH 03104
(877) 369-0928

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.