Provider Demographics
NPI:1720142029
Name:CARROLL COUNTY HEALTH AND HOME CARE SERVICES
Entity Type:Organization
Organization Name:CARROLL COUNTY HEALTH AND HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARYELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAROCHE
Authorized Official - Suffix:
Authorized Official - Credentials:RN MSN
Authorized Official - Phone:603-323-9394
Mailing Address - Street 1:PO BOX 420
Mailing Address - Street 2:
Mailing Address - City:CHOCORUA
Mailing Address - State:NH
Mailing Address - Zip Code:03817-0420
Mailing Address - Country:US
Mailing Address - Phone:603-323-9394
Mailing Address - Fax:603-323-7508
Practice Address - Street 1:448 WHITE MOUNTAIN HWY
Practice Address - Street 2:
Practice Address - City:CHOCORUA
Practice Address - State:NH
Practice Address - Zip Code:03817
Practice Address - Country:US
Practice Address - Phone:603-323-9394
Practice Address - Fax:603-323-7508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02895251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH99591002Medicaid