Myrtle Manor II, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

02233 Issued in NH

Legal business name

MYRTLE MANOR II, INC.

Practice address

83 Myrtle St
Manchester, NH 03104-6018

Phone

(603) 641-6626

Fax

(603) 641-6678

NPI assigned

May 16, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Suzanne Dorothy Dumont

Title

President

Phone

(603) 641-6626

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457568180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 MYRTLE ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031046018",
            "telephone_number": "603-641-6626",
            "fax_number": "603-641-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 MYRTLE ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031046018",
            "telephone_number": "603-641-6626",
            "fax_number": "603-641-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYRTLE MANOR II, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DUMONT",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "DOROTHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "603-641-6626",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NH",
            "license": "02233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Manchester, NH
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.