Basic Information
| Provider Information | |||||||||
| NPI: | 1437403037 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LIFE CHOICE HOSPICE OF NEW HAMPSHIRE, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 CADILLAC DR | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370275078 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153777022 | ||||||||
| FaxNumber: | 6153734457 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 HAMPTON RD STE 210 | ||||||||
| Address2: | |||||||||
| City: | EXETER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038334848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6039645183 | ||||||||
| FaxNumber: | 6039645280 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2012 | ||||||||
| LastUpdateDate: | 03/12/2020 | ||||||||
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| AuthorizedOfficialLastName: | ADKINS | ||||||||
| AuthorizedOfficialFirstName: | RUSSELL | ||||||||
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| AuthorizedOfficialTitleorPosition: | SVP GENERAL COUNSEL | ||||||||
| AuthorizedOfficialTelephone: | 6153095668 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251G00000X | Y | Agencies | Hospice Care, Community Based |
No ID Information.