Healthcare Provider Details

I. General information

NPI: 1528044971
Provider Name (Legal Business Name): THE EVENTIDE HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 HIGH ST
EXETER NH
03833-2908
US

IV. Provider business mailing address

81 HIGH STREET
EXETER NH
03833
US

V. Phone/Fax

Practice location:
  • Phone: 603-772-5743
  • Fax: 603-778-0241
Mailing address:
  • Phone: 603-772-5743
  • Fax: 603-778-0241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number730
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number00283
License Number StateNH

VIII. Authorized Official

Name: MS. KAREN JEAN UEBELE
Title or Position: ADMINISTRATOR
Credential:
Phone: 603-772-5743