Healthcare Provider Details

I. General information

NPI: 1477506178
Provider Name (Legal Business Name): SUMMIT HEALTH NEW HAMPSHIRE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 06/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 DANIEL WEBSTER HWY UNIT 11
BELMONT NH
03220-3053
US

IV. Provider business mailing address

171 DANIEL WEBSTER HWY UNIT 11
BELMONT NH
03220-3053
US

V. Phone/Fax

Practice location:
  • Phone: 603-524-3397
  • Fax: 603-524-9364
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: LISA A. CHAREST
Title or Position: OWNER MANAGING MEMBER
Credential: PT
Phone: 603-524-3397