- Enrollment id
- O20160329002576
- Enrollment state
- NH
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1659377869
- Multiple npi flag
- N
- Ccn
- 305102
- Associate id
- 7012091523
- Organization name
- COOS COUNTY NURSING HOME
- Doing business as name
- CAMDEN NATIONAL BANK
- Incorporation date
- 1976-05-17
- Incorporation state
- NH
- Organization type structure
- GOVERNMENT
- Proprietary nonprofit
- N
- Nursing home provider name
- COOS COUNTY NURSING HOME
- Address line 1
- 364 CATES HILL RD
- City
- BERLIN
- State
- NH
- Zip code
- 035701554