Provider Demographics
NPI:1851888002
Name:LINCOLN TERRACE HOME
Entity Type:Organization
Organization Name:LINCOLN TERRACE HOME
Other - Org Name:LINCOLN TERRACE HOME
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EROL
Authorized Official - Middle Name:
Authorized Official - Last Name:DUYMAZLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-455-6752
Mailing Address - Street 1:PO BOX 7185
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03839-7185
Mailing Address - Country:US
Mailing Address - Phone:603-455-6752
Mailing Address - Fax:603-335-6172
Practice Address - Street 1:11 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-3008
Practice Address - Country:US
Practice Address - Phone:603-330-3030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AS LIFE GOES ON, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-13
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04243310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3111768Medicaid