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General NPI Number Information
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NPI Number | 1982730693
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Entity Type | Organization
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Legal Business Name | ANDROSCOGGIN VALLEY HOME CARE SERVICES
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 795 MAIN ST
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City | BERLIN
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State | NH
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Zip | 03570-2437
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Country | US
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Telephone | 603-752-7505
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Fax | 603-752-4317
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Provider Business Mailing Address
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Address Line | 795 MAIN ST
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City | BERLIN
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State | NH
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Zip | 03570-2437
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Country | US
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Telephone | 603-752-7505
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Fax | 603-752-4317
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MARGO C SULLIVAN
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Credential | RN, BSN
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Telephone | 603-752-7505
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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 | 01938
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License Number State | NH
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