Provider Demographics
NPI:1750682563
Name:PROSPECT HILL HOME
Entity Type:Organization
Organization Name:PROSPECT HILL HOME
Other - Org Name:PROSPECT PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JANIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:603-352-6051
Mailing Address - Street 1:361 COURT ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-2503
Mailing Address - Country:US
Mailing Address - Phone:603-352-6051
Mailing Address - Fax:603-358-4065
Practice Address - Street 1:361 COURT ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-2503
Practice Address - Country:US
Practice Address - Phone:603-352-6051
Practice Address - Fax:603-358-4065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-10
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02391310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility