Provider Demographics
NPI: | 1821360546 |
---|---|
Name: | NORTH COUNTRY ACO |
Entity Type: | Organization |
Organization Name: | NORTH COUNTRY ACO |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | NANCY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | FRANK |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MPH |
Authorized Official - Phone: | 603-259-3700 |
Mailing Address - Street 1: | PO BOX 348 |
Mailing Address - Street 2: | |
Mailing Address - City: | LITTLETON |
Mailing Address - State: | NH |
Mailing Address - Zip Code: | 03561-0348 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 603-259-3700 |
Mailing Address - Fax: | 603-444-0945 |
Practice Address - Street 1: | 262 COTTAGE STREET |
Practice Address - Street 2: | SUITE 230 |
Practice Address - City: | LITTLETON |
Practice Address - State: | NH |
Practice Address - Zip Code: | 03561-4143 |
Practice Address - Country: | US |
Practice Address - Phone: | 603-259-3700 |
Practice Address - Fax: | 603-444-0945 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | NORTH COUNTRY HEALTH CONSORTIUM, INC |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2012-01-27 |
Last Update Date: | 2012-01-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NH | 251V00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251V00000X | Agencies | Voluntary or Charitable |