Healthcare Provider Details

I. General information

NPI: 1073688636
Provider Name (Legal Business Name): VALLEY REGIONAL HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 11/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

958 JOHN STARK HWY
NEWPORT NH
03773-2609
US

IV. Provider business mailing address

958 JOHN STARK HWY
NEWPORT NH
03773-2609
US

V. Phone/Fax

Practice location:
  • Phone: 603-543-6800
  • Fax:
Mailing address:
  • Phone: 603-543-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number02751
License Number StateNH

VIII. Authorized Official

Name: CARLA SKINDER JR.
Title or Position: COORDINATOR
Credential: RN
Phone: 603-543-6895