Interim Healthcare of the Neast, LLC
Organization Active NPI Home Health Agency · Manchester, NH
NPI 1164592085 · NPPES record last updated Mar 22, 2021
Key facts
- NPI
- 1164592085
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 01973 (NH)
- Legal business name
- INTERIM HEALTHCARE OF THE NEAST, LLC
- Practice address
- 608 Chestnut St
Manchester, NH 03104-1780 - Phone
- (603) 668-6956
- Fax
- (603) 668-6959
- NPI assigned
- Nov 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Sarah Ann Collier
- Title
- Operations Manager
- Phone
- (603) 668-6956
Corporate family (same tax ID) 1
Practitioners 4
-
Kendall Leduc, DPT
-
Gerald Nadeau, DC
-
Robert G Nadeau, DC
Affiliated clinicians 35
-
Eric R Benson, MD
-
Hannah E Boutselis, APRN
-
Jeffrey T Calegari, D.O
-
Catherine Coolidge, ARNP
-
Alexander David Davis, M.D.
-
Raphael Farra, M.D.
-
Sharon E. Ferguson, D.O.
-
Andrew Garber, M.D.
-
Douglas M Goumas, MD
-
Elizabeth Ann Hale, APRN
-
Michael Foster Kasschau, M.D.
-
Samuel T Kunkel, M.D.
-
Lance R Macey, MD
-
Safana Mushtaq, M.D.
-
Ira M Parsons IV, MD
-
Lisa A Profetto, ARNP
-
Akhilesh Sastry, MD
-
Gabrielle Ann Schuerman, ARNP, ND
-
Lucas D Shippee, DO
-
Dmitry Tarasevich, M.D.
-
Andrew Glenn Tremblay, M.D.
Medicare Care Compare: Home health agency
- Listed as
- Interim Healthcare
- Overall star rating
- ★★★★☆ 3.5 of 5
- Ownership
- Proprietary
- Certified
- Jun 7, 1982
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
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
- LLC · Proprietary
- Incorporated
- Apr 12, 1979 in NH
- Enrollment address
- 608 Chestnut Street
Manchester, NH 03105-1780
All disclosed owners & managing parties 2
| Name | Role | Since | Share |
|---|---|---|---|
| Richard a Petersen |
Corporate Officer |
Dec 31, 2020 | |
| Corporate Director | Jun 14, 2010 | ||
| Operational/Managerial Control | Jun 14, 2010 | ||
| Mark R Petersen |
5% Or Greater Direct Ownership Interest |
Oct 7, 2016 | 100% |
| Corporate Officer |
Oct 7, 2016 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100706000087 | NH | Part a Provider - Home Health Agency | 1759412869 | Practice locations: South Portland, ME; Portsmouth, NH; Nashua, NH; Laconia, NH; Auburn, ME; Manchester, NH |
National Provider Directory
- Tax ID family
- Interim Healthcare
Locations
336 Center St
Auburn, ME 04210
Phone (207) 777-1104
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
608 Chestnut St
Manchester, NH 03104
Phone (603) 668-6956
76 Northeastern Blvd
Ste 33A
Nashua, NH 03062
76 Northeastern Blvd
#33
Nashua, NH 03062
Phone (603) 880-4412
875 Greenland Rd
Unit B8
Portsmouth, NH 03801
Phone (603) 436-4155
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 01973 | NH | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80307049 | Medicaid | NH | |
| 99591010 | Medicaid | NH | |
| 609986 | Other | NH | TUFTS |
Other names
- Interim HealthCare
Other providers in Manchester, NH
- Janet Ingram
- Innovative Support Solutions LLC
- Inpatient Services of New Hampshire, PC
- Integrative Osteopathic Medicine & Healing Center, LLC
- Integrity Behavioral Care
- Interim Healthcare of the Neast, LLC
- Into Action Recovery Services LLC
- Lori Rosemary Iraheta-Yem
- Hazel J Irimpan
- Robert Daniel Irving
All providers in Manchester, NH · Home Health Agency in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.