Healthcare Provider Details

I. General information

NPI: 1376973511
Provider Name (Legal Business Name): NORTHERN NEW HAMPSHIRE HEALTHCARE COLLABORATIVE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2013
Last Update Date: 05/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

278 MAIN ST
LANCASTER NH
03584-3039
US

IV. Provider business mailing address

59 PAGE HILL RD
BERLIN NH
03570-3531
US

V. Phone/Fax

Practice location:
  • Phone: 800-750-2366
  • Fax: 603-788-5279
Mailing address:
  • Phone: 603-326-5625
  • Fax: 603-752-1836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number02626
License Number StateNH

VIII. Authorized Official

Name: MR. SCOTT W HOWE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 603-788-5030