Vintage Grace

NPI #1700902590 in Derry, New Hampshire

Provider Information

NPI Number: 1700902590
Entity Type: Organization
Organization Name: Vintage Grace
Primary Specialty: Program of All-Inclusive Care for the Elderly (PACE) Provider Organization
Enumeration Date: Mar 22, 2007
Last Updated: May 29, 2008

Practice Location

Address: 12 PEABODY RD
City: Derry
State: New Hampshire
ZIP Code: 03038-1838
Phone: (603) 425-6339

Authorized Official

Name: AMY BIZEUR
Title: DIRECTOR
Phone: (603) 425-6339

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Program of All-Inclusive Care for the Elderly (PACE) Provider Organization	251T00000X	Primary

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