Provider Demographics
NPI:1871619064
Name:SITROF LLC
Entity type:Organization
Organization Name:SITROF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-456-3181
Mailing Address - Street 1:3 DENNY HILL RD
Mailing Address - Street 2:
Mailing Address - City:WARNER
Mailing Address - State:NH
Mailing Address - Zip Code:03278-4505
Mailing Address - Country:US
Mailing Address - Phone:603-456-3181
Mailing Address - Fax:603-456-3933
Practice Address - Street 1:3 DENNY HILL RD
Practice Address - Street 2:
Practice Address - City:WARNER
Practice Address - State:NH
Practice Address - Zip Code:03278-4505
Practice Address - Country:US
Practice Address - Phone:603-456-3181
Practice Address - Fax:603-456-3933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02876310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30592386Medicaid