Provider Demographics
NPI:1093542524
Name:WISDOM HEALTHCARE LLC
Entity type:Organization
Organization Name:WISDOM HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ABDOU
Authorized Official - Middle Name:S
Authorized Official - Last Name:THIAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-895-7656
Mailing Address - Street 1:346 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAUGUS
Mailing Address - State:MA
Mailing Address - Zip Code:01906-3146
Mailing Address - Country:US
Mailing Address - Phone:617-895-7656
Mailing Address - Fax:
Practice Address - Street 1:346 MAIN ST
Practice Address - Street 2:
Practice Address - City:SAUGUS
Practice Address - State:MA
Practice Address - Zip Code:01906-3146
Practice Address - Country:US
Practice Address - Phone:617-895-7656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-18
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No333300000XSuppliersEmergency Response System Companies
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)