Provider Demographics
NPI:1447722590
Name:LITTLETON HOSPITAL ASSOCIATION
Entity type:Organization
Organization Name:LITTLETON HOSPITAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT, FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-444-9505
Mailing Address - Street 1:11 RIVERGLEN LN STE 150
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-5751
Mailing Address - Country:US
Mailing Address - Phone:603-259-1659
Mailing Address - Fax:603-259-1679
Practice Address - Street 1:11 RIVERGLEN LN STE 150
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561-5751
Practice Address - Country:US
Practice Address - Phone:603-259-1659
Practice Address - Fax:603-259-1679
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LITTLETON REGIONAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3080824Medicaid
NH3080825Medicaid
NH3080826Medicaid
NH3080827Medicaid