Healthcare Provider Details

I. General information

NPI: 1083693014
Provider Name (Legal Business Name): VNA AT HCS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 MARLBORO ST
KEENE NH
03431-4163
US

IV. Provider business mailing address

312 MARLBORO ST PO BOX 564
KEENE NH
03431-4163
US

V. Phone/Fax

Practice location:
  • Phone: 603-352-2253
  • Fax: 603-358-3904
Mailing address:
  • Phone: 603-352-2253
  • Fax: 603-358-3904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number02915
License Number StateNH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier99591036
Identifier TypeMEDICAID
Identifier StateNH
Identifier Issuer
# 2
Identifier80307046
Identifier TypeMEDICAID
Identifier StateNH
Identifier Issuer

VIII. Authorized Official

Name: MR. DAWN MICHELIZZI
Title or Position: CFO
Credential:
Phone: 603-352-2253