Healthcare Provider Details

I. General information

NPI: 1619908241
Provider Name (Legal Business Name): LAKE SUNAPEE HOMECARE AND HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 NEWPORT ROAD
NEW LONDON NH
03257
US

IV. Provider business mailing address

PO BOX 2209
NEW LONDON NH
03257-2209
US

V. Phone/Fax

Practice location:
  • Phone: 603-526-4077
  • Fax: 603-574-4343
Mailing address:
  • Phone: 603-526-4077
  • Fax: 603-574-4343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number030301
License Number StateNH

VIII. Authorized Official

Name: MR. JAMES CULHANE
Title or Position: CEO
Credential:
Phone: 603-526-4077