Provider Demographics
NPI:1336778208
Name:IMPRESS HEALTHCARE CORPORATION
Entity Type:Organization
Organization Name:IMPRESS HEALTHCARE CORPORATION
Other - Org Name:IMPRESS CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:CROCKER
Authorized Official - Suffix:
Authorized Official - Credentials:MSM
Authorized Official - Phone:603-239-0025
Mailing Address - Street 1:814 ELM ST STE 307
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-2130
Mailing Address - Country:US
Mailing Address - Phone:603-239-0025
Mailing Address - Fax:
Practice Address - Street 1:814 ELM ST STE 307
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-2130
Practice Address - Country:US
Practice Address - Phone:603-239-0025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-03
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management