Provider Demographics
NPI:1386362226
Name:WESTERN MASS INDIVIDUALIZED HOME CARE LLC
Entity type:Organization
Organization Name:WESTERN MASS INDIVIDUALIZED HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:NICE
Authorized Official - Middle Name:
Authorized Official - Last Name:NABITAKA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:413-450-1500
Mailing Address - Street 1:145 OLD AMHERST RD
Mailing Address - Street 2:
Mailing Address - City:BELCHERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01007-9745
Mailing Address - Country:US
Mailing Address - Phone:413-450-1500
Mailing Address - Fax:413-450-1550
Practice Address - Street 1:145 OLD AMHERST RD
Practice Address - Street 2:
Practice Address - City:BELCHERTOWN
Practice Address - State:MA
Practice Address - Zip Code:01007-9745
Practice Address - Country:US
Practice Address - Phone:413-450-1500
Practice Address - Fax:413-450-1550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-17
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty