Provider Demographics
NPI:1356912133
Name:UNITED CHURCH OF CHRIST RETIREMENT COMMUNITY INC
Entity type:Organization
Organization Name:UNITED CHURCH OF CHRIST RETIREMENT COMMUNITY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PALMIERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-229-1144
Mailing Address - Street 1:33 CHRISTIAN AVE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-6128
Mailing Address - Country:US
Mailing Address - Phone:603-224-5363
Mailing Address - Fax:603-227-1318
Practice Address - Street 1:33 CHRISTIAN AVE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-6128
Practice Address - Country:US
Practice Address - Phone:603-224-5363
Practice Address - Fax:603-229-1292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3078147Medicaid