Provider Demographics
NPI:1669948881
Name:AH KEENE LLC
Entity type:Organization
Organization Name:AH KEENE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:STODULSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-827-1700
Mailing Address - Street 1:6755 TELEGRAPH RD STE 330
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301-3182
Mailing Address - Country:US
Mailing Address - Phone:248-203-1800
Mailing Address - Fax:
Practice Address - Street 1:197 WATER ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-4240
Practice Address - Country:US
Practice Address - Phone:603-352-1282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility