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General NPI Number Information
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NPI Number | 1205096104
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Entity Type | Organization
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Legal Business Name | UPPER CONN VALLEY HOME HEALTH
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Dates
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Enumeration Date | 06/13/2008
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 120 MAIN ST SUITE 5
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City | COLEBROOK
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State | NH
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Zip | 03576-3086
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Country | US
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Telephone | 603-388-4201
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Fax |
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Provider Business Mailing Address
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Address Line | 181 CORLISS LN
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City | COLEBROOK
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State | NH
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Zip | 03576-3207
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Country | US
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Telephone | 603-388-4201
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Fax |
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Authorized Official
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Title or Position | FINANCIAL MANGER
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Name | MICHELLE ROUTHIER
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Credential |
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Telephone | 603-388-4201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 03272
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License Number State | NH
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