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NPI Code Detail

MEDICARE: ESTELLA HEALTH LLC

MEDICARE: ESTELLA HEALTH LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1467235671
Entity Type Code : Organization
Provider Name (Legal Business Name) : ESTELLA HEALTH LLC
Provider Business Mailing Address
First Line : 115 BROOK RD
Second Line :
City : QUINCY
State : MA
Zip : 02169-6528
Country : US
Telephone Number : 508-694-6687
Fax Number :
Provider Business Practice Location Address
First Line : 115 BROOK RD
Second Line :
City : QUINCY
State : MA
Zip : 02169-6528
Country : US
Telephone Number : 508-694-6687
Fax Number :
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : ALEXANDRE THEOHARIDIS
Credential :
Telephone Number : 508-694-6687
Provider Enumeration Date : 08/14/2023
Last Update Date : 08/14/2023

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Directions to “ESTELLA HEALTH LLC ” Practice Location

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