Provider Demographics
NPI:1194722553
Name:COURVILLE AT NASHUA, INC.
Entity type:Organization
Organization Name:COURVILLE AT NASHUA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CECILE
Authorized Official - Middle Name:P
Authorized Official - Last Name:MENARD
Authorized Official - Suffix:
Authorized Official - Credentials:RNC, MHA
Authorized Official - Phone:603-889-5450
Mailing Address - Street 1:22 HUNT ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-4426
Mailing Address - Country:US
Mailing Address - Phone:603-889-5450
Mailing Address - Fax:603-577-9796
Practice Address - Street 1:22 HUNT ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-4426
Practice Address - Country:US
Practice Address - Phone:603-889-5450
Practice Address - Fax:603-577-9796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH00651314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHNH00651OtherLICENSE
NH3071060Medicaid
NHNH00651OtherLICENSE