Provider Demographics
NPI:1427897479
Name:NORA NH 1 LLC
Entity type:Organization
Organization Name:NORA NH 1 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BULTHUIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-205-4770
Mailing Address - Street 1:49 FERSON RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755-3900
Mailing Address - Country:US
Mailing Address - Phone:360-920-4142
Mailing Address - Fax:
Practice Address - Street 1:49 FERSON RD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:NH
Practice Address - Zip Code:03755-3900
Practice Address - Country:US
Practice Address - Phone:360-920-4142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty