Provider Demographics
NPI:1114922788
Name:COOS COUNTY INSTITUTION
Entity Type:Organization
Organization Name:COOS COUNTY INSTITUTION
Other - Org Name:COOS COUNTY NURSING HOSPITAL
Other - Org Type:Other Name
Authorized Official - Title/Position:NURSING HOSPITAL ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:603-246-3321
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:WEST STEWARTSTOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03597-0010
Mailing Address - Country:US
Mailing Address - Phone:603-246-3321
Mailing Address - Fax:603-246-8117
Practice Address - Street 1:136 COUNTY FARM ROAD
Practice Address - Street 2:
Practice Address - City:WEST STEWARTSTOWN
Practice Address - State:NH
Practice Address - Zip Code:03597-0010
Practice Address - Country:US
Practice Address - Phone:603-246-3321
Practice Address - Fax:603-246-8117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-20
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH00049313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH99591031OtherNEW HAMPSHIRE RESPITE
VT030X201Medicaid
NH80877168Medicaid
NH80877168Medicaid