Healthcare Provider Details

I. General information

NPI: 1851819270
Provider Name (Legal Business Name): COMMUNITY HOUSE CALLS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2017
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

497 HOOKSETT ROAD 232
MANCHESTER NH
03104
US

IV. Provider business mailing address

497 HOOKSETT RD # 232
MANCHESTER NH
03104-2632
US

V. Phone/Fax

Practice location:
  • Phone: 16036068905
  • Fax: 603-935-7925
Mailing address:
  • Phone: 16036068905
  • Fax: 603-935-7925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: ANNE M WALLS
Title or Position: BUSINESS MANAGER
Credential:
Phone: 603-606-8905