Provider Demographics
NPI:1073210191
Name:LILYCARE OF NEW HAMPSHIRE LLC
Entity Type:Organization
Organization Name:LILYCARE OF NEW HAMPSHIRE LLC
Other - Org Name:LILYCARE OF NEW HAMPSHIRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-567-1990
Mailing Address - Street 1:9 CEDARWOOD DR. UNIT 6
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-3619
Mailing Address - Country:US
Mailing Address - Phone:603-802-6603
Mailing Address - Fax:603-802-6621
Practice Address - Street 1:9 CEDARWOOD DR UNIT 6
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6801
Practice Address - Country:US
Practice Address - Phone:603-802-6603
Practice Address - Fax:603-802-6621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-09
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based