Organization Name: | NIC 15 KIRKWOOD CORNERS LEASING LLC |
NPI Number: | 1689090292 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAUL BOETHEL (CEO) |
Mailing Address: | 206 N River Rd Lee |
State: | NH US |
Postal Code: | 038616214 |
Phone Number: | 6036596586 |
Fax Number: | |
NPI Enumeration Date: | 03/07/2014 |
NPI Last Update Date: | 03/26/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310400000X |
License Number: | 02985 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NH |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Assisted Living Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |