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General NPI Number Information
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NPI Number | 1841666146
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Entity Type | Organization
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Legal Business Name | INN AT PARKER STATION LLC
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Dates
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Enumeration Date | 08/20/2015
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Last Update Date | 08/20/2015
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Provider Practice Location Address
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Address Line | 46 PARKER STATION RD
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City | GOFFSTOWN
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State | NH
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Zip | 03045-3322
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Country | US
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Telephone | 603-497-5300
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Fax | 603-497-5300
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Provider Business Mailing Address
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Address Line | 46 PARKER STATION RD
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City | GOFFSTOWN
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State | NH
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Zip | 03045-3322
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Country | US
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Telephone | 603-497-5300
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Fax | 603-497-5300
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Authorized Official
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Title or Position | MANAGER
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Name | MR. ALEX AMANN
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Credential |
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Telephone | 603-497-5300
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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 | 02612
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License Number State | NH
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