Provider Demographics
NPI:1619908241
Name:LAKE SUNAPEE HOMECARE AND HOSPICE
Entity Type:Organization
Organization Name:LAKE SUNAPEE HOMECARE AND HOSPICE
Other - Org Name:LAKE SUNAPEE REGIONAL VNA AND HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CULHANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-526-4077
Mailing Address - Street 1:PO BOX 2209
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:NH
Mailing Address - Zip Code:03257-2209
Mailing Address - Country:US
Mailing Address - Phone:603-526-4077
Mailing Address - Fax:603-526-4272
Practice Address - Street 1:107 NEWPORT ROAD
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:NH
Practice Address - Zip Code:03257
Practice Address - Country:US
Practice Address - Phone:603-526-4077
Practice Address - Fax:603-526-4272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH030301251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH800566OtherBCBS HOSPICE PROVIDER NUM
NH800566OtherBCBS HOSPICE PROVIDER NUM