Provider Demographics
NPI:1578635280
Name:VALLEY REGIONAL HEALTHCARE, INC.
Entity Type:Organization
Organization Name:VALLEY REGIONAL HEALTHCARE, INC.
Other - Org Name:CONNECTICUT VALLEY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM HOME CARE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:603-543-6800
Mailing Address - Street 1:958 JOHN STARK HWY
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:NH
Mailing Address - Zip Code:03773-2609
Mailing Address - Country:US
Mailing Address - Phone:603-543-6800
Mailing Address - Fax:
Practice Address - Street 1:958 JOHN STARK HWY
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:NH
Practice Address - Zip Code:03773-2609
Practice Address - Country:US
Practice Address - Phone:603-543-6800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02446251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH40307001Medicaid
NH49591030Medicaid
NH307001AMedicare Oscar/Certification