Provider Demographics
NPI:1689217960
Name:COMMONWEALTH SENIOR CARE, LLC
Entity Type:Organization
Organization Name:COMMONWEALTH SENIOR CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAITLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-489-3529
Mailing Address - Street 1:51A CHENEY LN
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:NH
Mailing Address - Zip Code:03819-3301
Mailing Address - Country:US
Mailing Address - Phone:603-489-3529
Mailing Address - Fax:
Practice Address - Street 1:231 SUTTON ST STE 2H
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-1620
Practice Address - Country:US
Practice Address - Phone:978-725-5995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-19
Last Update Date:2019-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAUNKNOWNOtherCOMMONWEALTH CARE ALLIANCE