Provider Demographics
NPI:1891135695
Name:PROFESSIONAL HOME HEALTH CARE OF NH, INC
Entity Type:Organization
Organization Name:PROFESSIONAL HOME HEALTH CARE OF NH, INC
Other - Org Name:RIGHT AT HOME OF SOUTHERN NH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-216-9296
Mailing Address - Street 1:150 NASHUA RD
Mailing Address - Street 2:UNIT C
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3642
Mailing Address - Country:US
Mailing Address - Phone:603-216-9296
Mailing Address - Fax:603-216-9297
Practice Address - Street 1:150 NASHUA RD
Practice Address - Street 2:UNIT C
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3642
Practice Address - Country:US
Practice Address - Phone:603-216-9296
Practice Address - Fax:603-216-9297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-26
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03367251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3076559Medicaid