Basic Information
| Provider Information | |||||||||
| NPI: | 1912986316 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WARDE HEALTH CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21 SEARLES RD | ||||||||
| Address2: | |||||||||
| City: | WINDHAM | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030871203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6038901290 | ||||||||
| FaxNumber: | 6038901293 | ||||||||
| Practice Location | |||||||||
| Address1: | 21 SEARLES RD | ||||||||
| Address2: | |||||||||
| City: | WINDHAM | ||||||||
| State: | NH | ||||||||
| PostalCode: | 030871203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6038901290 | ||||||||
| FaxNumber: | 6038901293 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2006 | ||||||||
| LastUpdateDate: | 01/16/2014 | ||||||||
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| AuthorizedOfficialLastName: | DENOPOULOS | ||||||||
| AuthorizedOfficialFirstName: | SUE | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR, PRESIDENT OF CORP. | ||||||||
| AuthorizedOfficialTelephone: | 6038901290 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | NHA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 01943 | NH | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | 3078166 | 05 | NH | MEDICAID |