Provider Demographics
NPI:1427051598
Name:VISITING NURSE ASSOCIATION OF BOSTON
Entity type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF BOSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:508-573-8092
Mailing Address - Street 1:67 MILLBROOK STREET
Mailing Address - Street 2:500 NORTH
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2835
Mailing Address - Country:US
Mailing Address - Phone:800-521-5539
Mailing Address - Fax:508-751-6875
Practice Address - Street 1:97 LIBBEY INDUSTRIAL PARKWAY
Practice Address - Street 2:SUITE 301
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-3110
Practice Address - Country:US
Practice Address - Phone:800-521-5539
Practice Address - Fax:508-786-1990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227068251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110024172BMedicaid
MA227068Medicare ID - Type UnspecifiedPROVIDER NUMBER