Malley Farm Boys Home Inc.

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

1077 Issued in NH

Legal business name

MALLEY FARM BOYS HOME INC.

Practice address

250 Indigo Hill Rd
Somersworth, NH 03878-2917

Phone

(603) 692-5479

Fax

(603) 692-5956

NPI assigned

May 7, 2007

Organization subpart

No

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

Authorized official

Name

Mark H Sipple

Title

Executive Director

Phone

(603) 692-5479

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376756528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 INDIGO HILL RD",
            "city": "SOMERSWORTH",
            "state": "NH",
            "postal_code": "038782917",
            "telephone_number": "603-692-5479",
            "fax_number": "603-692-5956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 INDIGO HILL RD",
            "city": "SOMERSWORTH",
            "state": "NH",
            "postal_code": "038782917",
            "telephone_number": "603-692-5479",
            "fax_number": "603-692-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALLEY FARM BOYS HOME INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIPPLE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "603-692-5479"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NH",
            "license": "1077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30007100",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30830125",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Collin Maberry, PT, DPT
• Thomas HD Mackenzie
• William E Maher, M.D.
• Dalia Mahmoud Hassan Elamin, MD
• Dawn Mahoney
• Manchester Vamc
• Stephanie Mandani, CNM
• Irene Maranga
• Megan Marasca, DPT
• Kristine Mae Markuns, RPH

• Emotionally Disturbed Childrens' Residential Treatment Facility in Somersworth, NH
• Providers in Somersworth, NH by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.