NPIMap

Organization Active NPI

Cedarcrest, Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Keene, NH
National Provider Identifier
1699897215
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
1709 Issued in NH
Legal business name
CEDARCREST, INC.
Practice address
91 Maple Ave
Keene, NH 03431-1629
Phone
(603) 358-3384
Fax
(603) 358-6485
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Scott Q. Adams, BA, BS, MBA
Title
Cfo
Phone
(603) 385-3384

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 1709 NH Primary

Addresses

Primary practice location

91 Maple Ave
Keene, NH 03431-1629

Mailing address

91 Maple Ave
Keene, NH 03431-1629
Phone (603) 358-3384

Other identifiers 2

IdentifierTypeStateIssuer
80848084MedicaidNH
030G001MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 30G001

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CEDARCREST INC
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Feb 1, 1978
Last certification
Feb 4, 2025
Beds
28
Ownership / control type
Private (non-profit)
Facility address
91 Maple Avenue
Keene, NH 03431

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
30D2041628Cedarcrest Inc91 Maple Avenue, Keene, NH 03431Certificate of waiverMay 24, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699897215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 MAPLE AVE",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034311629",
            "telephone_number": "603-358-3384",
            "fax_number": "603-358-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 MAPLE AVE",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034311629",
            "telephone_number": "603-358-3384",
            "fax_number": "603-358-6485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDARCREST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "Q.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "603-385-3384",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BA, BS, MBA"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NH",
            "license": "1709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80848084",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030G001",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

Verify at the official NPI Registry.