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General NPI Number Information
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NPI Number | 1376096891
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Entity Type | Organization
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Legal Business Name | TAMWORTH COMMUNITY LIVING INC
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Dates
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Enumeration Date | 08/02/2016
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Last Update Date | 08/02/2016
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Provider Practice Location Address
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Address Line | 22 MAYS WAY
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City | WEST OSSIPEE
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State | NH
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Zip | 03890-4467
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Country | US
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Telephone | 603-323-8717
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Fax |
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Provider Business Mailing Address
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Address Line | 22 MAYS WAY
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City | WEST OSSIPEE
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State | NH
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Zip | 03890-4467
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Country | US
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Telephone | 603-323-8717
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DIDIE WATSOP
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Credential |
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Telephone | 508-423-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 04165
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License Number State | NH
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