Provider Demographics
NPI:1306451505
Name:DOVE HOSPICE OF MASSACHUSETTS LLC
Entity type:Organization
Organization Name:DOVE HOSPICE OF MASSACHUSETTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:BERTELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-305-3035
Mailing Address - Street 1:303 WYMAN ST STE 300
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1255
Mailing Address - Country:US
Mailing Address - Phone:732-405-3035
Mailing Address - Fax:732-405-3055
Practice Address - Street 1:303 WYMAN ST STE 300
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1255
Practice Address - Country:US
Practice Address - Phone:732-405-3035
Practice Address - Fax:732-405-3055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based