Healthcare Provider Details

I. General information

NPI: 1578262317
Provider Name (Legal Business Name): SUMMIT NEW HAMPSHIRE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2023
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 ELM ST STE NO406
MANCHESTER NH
03104-2907
US

IV. Provider business mailing address

1750 ELM ST STE NO406
MANCHESTER NH
03104-2907
US

V. Phone/Fax

Practice location:
  • Phone: 603-232-7194
  • Fax:
Mailing address:
  • Phone: 603-232-7194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBIN THAPA
Title or Position: PRESIDENT
Credential:
Phone: 603-232-7194