Providence House Eldercare Services

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

04108 Issued in NH

Legal business name

PROVIDENCE HOUSE ELDERCARE SERVICES

Practice address

25 Main St
Rochester, NH 03868-8449

Phone

(207) 459-4521

NPI assigned

Nov 22, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Albert Mutascio

Title

Administrator

Phone

(603) 822-2386

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1448150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448150400000",
    "number": "1962876334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MAIN ST",
            "city": "ROCHESTER",
            "state": "NH",
            "postal_code": "038688449",
            "telephone_number": "207-459-4521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MAIN ST",
            "city": "ROCHESTER",
            "state": "NH",
            "postal_code": "038688449",
            "telephone_number": "207-459-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HOUSE ELDERCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-22",
        "last_updated": "2015-11-22",
        "status": "A",
        "authorized_official_last_name": "MUTASCIO",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "603-822-2386",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NH",
            "license": "04108",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NH",
            "license": "04108",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Plante
• Catherine Plasse, LICSW, MLADC, CCTP
• Cynthia J Porter, PT
• Danielle Prevost
• Cadence Proctor, MSPT, DPT
• Silke Psula
• Psychotherapy Associates, Inc.
• Taylor Purcell
• Lucy Putnam, LCMHC
• Austin Lee Rallis, MD, PHD

• Assisted Living Facility in Rochester, NH
• Providers in Rochester, NH by specialty
• Assisted Living Facility in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2015; 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.