Provider Demographics
NPI:1497022016
Name:DISTINCTIVE HOME CARE SOLUTIONS
Entity Type:Organization
Organization Name:DISTINCTIVE HOME CARE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:E
Authorized Official - Last Name:GOSSELIN
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:603-556-7797
Mailing Address - Street 1:PO BOX 272
Mailing Address - Street 2:
Mailing Address - City:GILMANTON IRON WORKS
Mailing Address - State:NH
Mailing Address - Zip Code:03837-0272
Mailing Address - Country:US
Mailing Address - Phone:603-556-7797
Mailing Address - Fax:
Practice Address - Street 1:39 WHITE OAK RD
Practice Address - Street 2:
Practice Address - City:GILMANTON IRON WORKS
Practice Address - State:NH
Practice Address - Zip Code:03837-5314
Practice Address - Country:US
Practice Address - Phone:603-556-7797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03746251B00000X, 251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care