Vintage Grace

LBN: Vintage Grace
Vintage Grace is an health care organization with primary practice located at 12 Peabody Rd , Derry NH 03038-1838. The organization recently has only one registered license in Agencies / Program of All-Inclusive Care for the Elderly (PACE) Provider Organization, which is considered as the primary health care specialty. Vintage Grace can be contacted via phone (603) 425-6339, or through Bizeur, Amy via phone (603) 425-6339.

Contact Information

Primary practice address
12 Peabody Rd Derry NH 03038-1838
Phone: (603) 425-6339
Fax: (603) 421-9367
Website:
Map and Directions
Authorized official contact:
Name: Bizeur, Amy
Phone: (603) 425-6339

Health care specialties

SpecialtyCodeLicense #State
Agencies / Program of All-Inclusive Care for the Elderly (PACE) Provider Organization 251T00000X 251T00000X New Hampshire

Profile Details

NPI number 1700902590
LBN Legal business name Vintage Grace
DBA Doing business as
Authorized official Bizeur, Amy
Entity Organization
Organization subpart 1 No
Enumeration date Mar 22nd, 2007
Last updated May 29th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700902590 NPPES
New Hampshire MEDICAID 30009906
New Hampshire MEDICAID 30009905

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