Provider Demographics
NPI:1184605941
Name:UNITED CHURCH OF CHRIST RETIREMENT COMMUNITY INC
Entity type:Organization
Organization Name:UNITED CHURCH OF CHRIST RETIREMENT COMMUNITY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PALMIERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-229-1144
Mailing Address - Street 1:33 CHRISTIAN AVE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-6128
Mailing Address - Country:US
Mailing Address - Phone:603-224-5363
Mailing Address - Fax:603-229-1188
Practice Address - Street 1:33 CHRISTIAN AVE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-6128
Practice Address - Country:US
Practice Address - Phone:603-224-5363
Practice Address - Fax:603-229-1188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH01727251E00000X
NH00577310400000X, 314000000X
NH02431310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80305016Medicaid
NH80305016Medicaid