Provider Demographics
NPI:1609467463
Name:HOME HEALTH CARE SPECIALISTS OF SOUTHERN ME AND NH
Entity Type:Organization
Organization Name:HOME HEALTH CARE SPECIALISTS OF SOUTHERN ME AND NH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:COSTELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-504-9714
Mailing Address - Street 1:46 HUBBARD RD
Mailing Address - Street 2:
Mailing Address - City:BERWICK
Mailing Address - State:ME
Mailing Address - Zip Code:03901-2342
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1024 SUNCOOK VALLEY HWY UNIT D1
Practice Address - Street 2:
Practice Address - City:EPSOM
Practice Address - State:NH
Practice Address - Zip Code:03234-4149
Practice Address - Country:US
Practice Address - Phone:978-504-9714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-03
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1649817750OtherHOME HEALTH AIDE