Provider Demographics
NPI:1164592085
Name:INTERIM HEALTHCARE OF THE NEAST, LLC
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE OF THE NEAST, LLC
Other - Org Name:INTERIM HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-668-6956
Mailing Address - Street 1:608 CHESTNUT ST
Mailing Address - Street 2:P O BOX 1780
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-1780
Mailing Address - Country:US
Mailing Address - Phone:603-668-6956
Mailing Address - Fax:603-668-6959
Practice Address - Street 1:608 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-1780
Practice Address - Country:US
Practice Address - Phone:603-668-6956
Practice Address - Fax:603-668-6959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH01973251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80307049Medicaid
NH99591010Medicaid
NH609986OtherTUFTS
NH99591010Medicaid