Provider Demographics
NPI:1174673354
Name:LAKES REGION COMMUNITY SERVICES
Entity Type:Organization
Organization Name:LAKES REGION COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-524-8811
Mailing Address - Street 1:PO BOX 509
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03247-0509
Mailing Address - Country:US
Mailing Address - Phone:603-524-8811
Mailing Address - Fax:603-524-0288
Practice Address - Street 1:67 COMMUNICATION DR
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-1440
Practice Address - Country:US
Practice Address - Phone:603-524-8811
Practice Address - Fax:603-524-0288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1426225100000X
NH1476225X00000X
NH0291235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH13Y003040NH01OtherOT
NH13Y010620NH01OtherOT
NH0805719Y0NH01OtherPT
NH6606699Y0NH01OtherSLP
NH6607748Y0NH02OtherSLP
NH6605607Y0NH02OtherSLP