North Country Independent Living Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

NORTH COUNTRY INDEPENDENT LIVING INC

Practice address

2541 White Mountain Hwy Ste 3
North Conway, NH 03860-5125

Phone

(603) 356-0282

Fax

(603) 356-0283

NPI assigned

Jun 14, 2021

Organization subpart

No

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

Authorized official

Name

Garry Sherry

Title

Chief Executive Officer

Phone

(603) 356-0282

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1962070250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 518",
            "city": "NORTH CONWAY",
            "state": "NH",
            "postal_code": "038600518",
            "telephone_number": "603-356-0282",
            "fax_number": "603-356-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2541 WHITE MOUNTAIN HWY STE 3",
            "city": "NORTH CONWAY",
            "state": "NH",
            "postal_code": "038605125",
            "telephone_number": "603-356-0282",
            "fax_number": "603-356-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COUNTRY INDEPENDENT LIVING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "SHERRY",
        "authorized_official_first_name": "GARRY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "603-356-0282"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in North Conway, NH
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.