NPIMap

Organization Active NPI

Interim Healthcare of the Neast, LLC

Doing business as Interim HealthCare

  • Home Health Agency
  • Manchester, NH
National Provider Identifier
1164592085
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
01973 Issued in NH
Legal business name
INTERIM HEALTHCARE OF THE NEAST, LLC
Doing business as
Interim HealthCare
Practice address
608 Chestnut St
Manchester, NH 03104-1780
Phone
(603) 668-6956
Fax
(603) 668-6959
NPI assigned
Nov 8, 2006
Last updated
Mar 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sarah Ann Collier
Title
Operations Manager
Phone
(603) 668-6956

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 01973 NH Primary

Addresses

Primary practice location

608 Chestnut St
Manchester, NH 03104-1780

Mailing address

608 Chestnut St
P O Box 1780
Manchester, NH 03104-1780
Phone (603) 668-6956

Other names 1

  • Interim HealthCare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100706000087 NH Part A Provider - Home Health Agency 1759412869 Practice locations: South Portland, ME; Portsmouth, NH; Nashua, NH; Laconia, NH; Auburn, ME; Manchester, NH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164592085. Details of each certification follow.

Home health agency certification: CCN 307049

Legal name
INTERIM HEALTHCARE OF THE NEAST, LLC
Doing business as
INTERIM HEALTHCARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 7, 1982
Last certification
Jan 10, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Apr 12, 1979 in NH
Enrollment address
608 Chestnut Street
Manchester, NH 03105-1780
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Interim HealthcareCCN 307049 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Jun 7, 1982
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Interim Healthcare2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

336 Center St
Unit 7
Auburn, ME 04210

15 Westminster St
Lewiston, ME 04240
Phone (207) 783-6700

20 Atlantic Pl
South Portland, ME 04106

403 Winchester St
Keene, NH 03431
Phone (603) 352-7290

277 Union Ave
Ste 202
Laconia, NH 03246
Phone (603) 524-7212

366 Union Ave
#3
Laconia, NH 03246
Phone (603) 524-7212

76 Northeastern Blvd
#33
Nashua, NH 03062
Phone (603) 880-4412

76 Northeastern Blvd
Ste 33A
Nashua, NH 03062

875 Greenland Rd
Unit B8
Portsmouth, NH 03801
Phone (603) 436-4155

875 Greenland Rd
Unit C1
Portsmouth, NH 03801
Phone (603) 433-4992

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Richard a Petersen Individual Corporate OfficerPresident Dec 31, 2020
Corporate Director Jun 14, 2010
Operational/Managerial Control Jun 14, 2010
Mark R Petersen Individual 5% Or Greater Direct Ownership InterestVice President Oct 7, 2016 100%
Corporate OfficerVice President Oct 7, 2016 100%

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 35

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 35

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616371200000",
    "number": "1164592085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 CHESTNUT ST",
            "address_2": "P O BOX 1780",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031041780",
            "telephone_number": "603-668-6956",
            "fax_number": "603-668-6959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 CHESTNUT ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031041780",
            "telephone_number": "603-668-6956",
            "fax_number": "603-668-6959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERIM HEALTHCARE OF THE NEAST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A",
        "authorized_official_last_name": "COLLIER",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "603-668-6956"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NH",
            "license": "01973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Interim HealthCare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Interim HealthCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.