Basic Information
| Provider Information | |||||||||
| NPI: | 1407806631 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HOPEHEALTH COMMUNITY VISITING NURSE AGENCY, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 EMORY ST | ||||||||
| Address2: | |||||||||
| City: | ATTLEBORO | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027033002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5082220118 | ||||||||
| FaxNumber: | 5082261012 | ||||||||
| Practice Location | |||||||||
| Address1: | 10 EMORY ST | ||||||||
| Address2: | |||||||||
| City: | ATTLEBORO | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027033002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5082220118 | ||||||||
| FaxNumber: | 5082261012 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2006 | ||||||||
| LastUpdateDate: | 04/08/2022 | ||||||||
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| AuthorizedOfficialLastName: | KANE | ||||||||
| AuthorizedOfficialFirstName: | ADOZINDA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 4015858875 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| NPICertificationDate: | 04/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | MA | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | 0699381 | 05 | MA | MEDICAID | 0605107 | 05 | MA | MEDICAID |