Provider Demographics
NPI:1134216849
Name:LAKE SUNAPEE COMMUNITY HEALTH SERVICES
Entity type:Organization
Organization Name:LAKE SUNAPEE COMMUNITY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:F
Authorized Official - Last Name:MALANGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-526-4077
Mailing Address - Street 1:PO BOX 2209
Mailing Address - Street 2:107 NEWPORT ROAD
Mailing Address - City:NEW LONDON
Mailing Address - State:NH
Mailing Address - Zip Code:03257-2209
Mailing Address - Country:US
Mailing Address - Phone:603-526-4077
Mailing Address - Fax:603-574-4343
Practice Address - Street 1:107 NEWPORT ROAD
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:NH
Practice Address - Zip Code:03257-2209
Practice Address - Country:US
Practice Address - Phone:603-526-4077
Practice Address - Fax:603-574-4343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03030251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30004854Medicaid
NH30005518Medicaid