Provider Demographics
NPI:1386692200
Name:GARDNER VISITING NURSING ASSOCIATION INC
Entity type:Organization
Organization Name:GARDNER VISITING NURSING ASSOCIATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLUET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-632-1230
Mailing Address - Street 1:34 PEARLY LN
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440
Mailing Address - Country:US
Mailing Address - Phone:978-632-1230
Mailing Address - Fax:978-632-4513
Practice Address - Street 1:34 PEARLY LN
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440
Practice Address - Country:US
Practice Address - Phone:978-632-1230
Practice Address - Fax:978-632-4513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare