Healthcare Provider Details

I. General information

NPI: 1831199488
Provider Name (Legal Business Name): UPPER CONNECTICUT VALLEY HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 CORLISS LN
COLEBROOK NH
03576-3207
US

IV. Provider business mailing address

181 CORLISS LN
COLEBROOK NH
03576-3207
US

V. Phone/Fax

Practice location:
  • Phone: 603-237-4971
  • Fax: 603-237-9834
Mailing address:
  • Phone: 603-237-4971
  • Fax: 603-237-9834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number02092
License Number StateNH

VIII. Authorized Official

Name: MRS. SHARON E. COVILL
Title or Position: DIRECTOR
Credential: RN,BSN
Phone: 603-237-4971