- Enrollment id
- O20110210000197
- Enrollment state
- NH
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1689981193
- Multiple npi flag
- N
- Ccn
- 301532
- Associate id
- 1254511165
- Organization name
- BROOKHAVEN HOSPICE OF NEW HAMPSHIRE, LLC
- Incorporation date
- 2010-05-27
- Incorporation state
- NH
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 2 BEDFORD FARMS DR
- Address line 2
- STE 105
- City
- BEDFORD
- State
- NH
- Zip code
- 031106525