=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154255206
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MANCHESTER HEALTH SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/11/2026
-----------------------------------------------------
Last Update Date | 06/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 769 S MAIN ST STE 201
-----------------------------------------------------
City | MANCHESTER
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03102-5166
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-641-6700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 769 S MAIN ST STE 201
-----------------------------------------------------
City | MANCHESTER
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03102-5166
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-641-6700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | PAMELA MARTEL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 603-663-6180
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR0401X
-----------------------------------------------------
Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------