Provider Demographics
NPI:1508860875
Name:VNA-HOSPICE OF SOUTHERN CARROLL COUNTY & VICINITY,INC.
Entity Type:Organization
Organization Name:VNA-HOSPICE OF SOUTHERN CARROLL COUNTY & VICINITY,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:LABAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-569-2729
Mailing Address - Street 1:PO BOX 1620
Mailing Address - Street 2:
Mailing Address - City:WOLFEBORO
Mailing Address - State:NH
Mailing Address - Zip Code:03894-1620
Mailing Address - Country:US
Mailing Address - Phone:603-569-2729
Mailing Address - Fax:603-569-2409
Practice Address - Street 1:240 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WOLFEBORO
Practice Address - State:NH
Practice Address - Zip Code:03894-4411
Practice Address - Country:US
Practice Address - Phone:603-569-2729
Practice Address - Fax:603-569-2409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-02
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH01937251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80307016Medicaid
NH30531886Medicaid
NH99591034Medicaid
NH30531886Medicaid