Provider Demographics
NPI:1477506178
Name:SUMMIT HEALTH NEW HAMPSHIRE LLC
Entity Type:Organization
Organization Name:SUMMIT HEALTH NEW HAMPSHIRE LLC
Other - Org Name:SUMMIT HEALTH NH LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHAREST
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:603-524-3397
Mailing Address - Street 1:171 DANIEL WEBSTER HWY
Mailing Address - Street 2:UNIT 11
Mailing Address - City:BELMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03220-3053
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:171 DANIEL WEBSTER HWY
Practice Address - Street 2:UNIT 11
Practice Address - City:BELMONT
Practice Address - State:NH
Practice Address - Zip Code:03220-3053
Practice Address - Country:US
Practice Address - Phone:603-524-3397
Practice Address - Fax:603-524-9364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE6237Medicare UPIN
NHRE6209Medicare UPIN
NHRE6237Medicare ID - Type Unspecified
NHRE6209Medicare UPIN