Provider Demographics
NPI:1871250787
Name:CARPENTER HALL LLC
Entity Type:Organization
Organization Name:CARPENTER HALL LLC
Other - Org Name:ZINNIA EXETER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHEGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-490-7933
Mailing Address - Street 1:251 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:RI
Mailing Address - Zip Code:02822-3531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:251 MAIN ST
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:RI
Practice Address - Zip Code:02822-3531
Practice Address - Country:US
Practice Address - Phone:657-304-0103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-26
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility