NPIMap

Organization Active NPI

Salemhaven, Inc.

Doing business as Salemhaven Nursing Home

  • Skilled Nursing Facility
  • Salem, NH
National Provider Identifier
1366438491
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
02630 Issued in NH
Legal business name
SALEMHAVEN, INC.
Doing business as
Salemhaven Nursing Home
Practice address
23 Geremonty Dr
Salem, NH 03079-3314
Phone
(603) 893-5586
Fax
(603) 893-4394
NPI assigned
Sep 23, 2005
Last updated
Jan 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Raymond Milliard
Title
Administrator
Phone
(603) 893-5586

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 02630 NH Primary

Addresses

Primary practice location

23 Geremonty Dr
Salem, NH 03079-3314

Mailing address

23 Geremonty Dr
Salem, NH 03079-3314
Phone (603) 893-5586

Other names 1

  • Salemhaven Nursing Home Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120210000217 NH Part A Provider - Skilled Nursing Facility 8123285657 Practice locations: Salem, NH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366438491. Details of each certification follow.

Skilled nursing facility certification: CCN 305058

Legal name
SALEMHAVEN, INC.
Doing business as
SALEMHAVEN NURSING HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1996
Last certification
Aug 8, 2024
Beds
110
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Feb 1, 1972 in NH
Enrollment address
23 Geremonty Dr
Salem, NH 03079-3314
Nursing home name
SALEMHAVEN

Care Compare: Nursing home

Medicare Care Compare
Listed as
SalemhavenCCN 305058 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jan 1, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11088.8 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Salemhaven Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kathy Murray-Potrin Individual Corporate OfficerBoard President Sep 1, 2016 100%
Corporate DirectorBusiness Manager/Cfo Dec 1, 1979 50%
Raymond Milliard Individual Contracted Managing EmployeeCeo Apr 3, 2003 100%
Corporate DirectorCeo Apr 3, 2003 100%
Covenant Health Organization, Tewksbury, MA Corporation, Management services company, Non-profit Operational/Managerial Control Apr 1, 2001 100%

Facilities with the same owner 14

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 14

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326326400000",
    "number": "1366438491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 GEREMONTY DR",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030793314",
            "telephone_number": "603-893-5586",
            "fax_number": "603-893-4394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 GEREMONTY DR",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030793314",
            "telephone_number": "603-893-5586",
            "fax_number": "603-893-4394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALEMHAVEN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-23",
        "last_updated": "2012-01-12",
        "status": "A",
        "authorized_official_last_name": "MILLIARD",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "603-893-5586",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NH",
            "license": "02630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Salemhaven Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, NH

Sources for this page

Verify at the official NPI Registry.