- Enrollment id
- O20260205002266
- Enrollment state
- NH
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1457242414
- Multiple npi flag
- N
- Ccn
- 305020
- Associate id
- 5698254159
- Organization name
- HANOVER TERRACE LLC
- Doing business as name
- HANOVER TERRACE HEALTH AND REHABILITATION
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- HANOVER TERRACE HEALTH AND REHABILITATION
- Address line 1
- 49 LYME RD
- City
- HANOVER
- State
- NH
- Zip code
- 037551205