Provider Demographics
NPI:1972078293
Name:CAMPBELL HOUSE, LLC
Entity Type:Organization
Organization Name:CAMPBELL HOUSE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-826-0840
Mailing Address - Street 1:8 KAREN PL
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-4279
Mailing Address - Country:US
Mailing Address - Phone:603-953-5513
Mailing Address - Fax:603-953-5513
Practice Address - Street 1:164 OLD SPRINGFIELD RD
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:NH
Practice Address - Zip Code:03603-4504
Practice Address - Country:US
Practice Address - Phone:603-826-0840
Practice Address - Fax:603-826-0839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-13
Last Update Date:2020-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility