Provider Demographics
NPI:1003029901
Name:TERRACE COMMUNITIES HANOVER, LLC
Entity Type:Organization
Organization Name:TERRACE COMMUNITIES HANOVER, LLC
Other - Org Name:WHEELOCK TERRACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABBOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-252-6644
Mailing Address - Street 1:32 BUCK RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755
Mailing Address - Country:US
Mailing Address - Phone:603-643-7290
Mailing Address - Fax:603-643-2694
Practice Address - Street 1:32 BUCK RD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-2700
Practice Address - Country:US
Practice Address - Phone:603-643-7290
Practice Address - Fax:603-643-2694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02767310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH02767OtherSTATE LICENSE