Provider Demographics
NPI:1861481681
Name:VISITING NURSE AT HIGHLAND, INC
Entity type:Organization
Organization Name:VISITING NURSE AT HIGHLAND, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:CORNELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:617-776-9800
Mailing Address - Street 1:186 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-1507
Mailing Address - Country:US
Mailing Address - Phone:617-776-4420
Mailing Address - Fax:617-629-7926
Practice Address - Street 1:186 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-1507
Practice Address - Country:US
Practice Address - Phone:617-776-4420
Practice Address - Fax:617-629-7926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-14
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0787311Z00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0999032Medicaid
MA225470Medicare PIN