Provider Demographics
NPI:1194960229
Name:APPLEGATE GARDENS, LLC.
Entity type:Organization
Organization Name:APPLEGATE GARDENS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-539-1080
Mailing Address - Street 1:PO BOX 644
Mailing Address - Street 2:
Mailing Address - City:WOLFEBORO FALLS
Mailing Address - State:NH
Mailing Address - Zip Code:03896-0644
Mailing Address - Country:US
Mailing Address - Phone:603-539-1080
Mailing Address - Fax:603-539-1080
Practice Address - Street 1:141 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:CENTER TUFTONBORO
Practice Address - State:NH
Practice Address - Zip Code:03816-5053
Practice Address - Country:US
Practice Address - Phone:603-539-1080
Practice Address - Fax:603-539-1080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03380311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home