Healthcare Provider Details
I. General information
NPI: 1669780425
Provider Name (Legal Business Name): COMMUNITY PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/15/2010
Last Update Date: 12/29/2023
Certification Date: 12/29/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
113 CROSBY RD SUITE #1
DOVER NH
03820-4370
US
IV. Provider business mailing address
113 CROSBY RD SUITE #1
DOVER NH
03820-4370
US
V. Phone/Fax
- Phone: 603-516-9300
- Fax: 603-740-9179
- Phone: 603-516-9300
- Fax: 603-740-9179
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SUZANNE
BAGDASARIAN
Title or Position: CFO
Credential:
Phone: 603-516-9522