Healthcare Provider Details

I. General information

NPI: 1790788743
Provider Name (Legal Business Name): CHICOPEE VISITING NURSE ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 01/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 WESTOVER RD
CHICOPEE MA
01022-1079
US

IV. Provider business mailing address

2024 WESTOVER RD
CHICOPEE MA
01022-1079
US

V. Phone/Fax

Practice location:
  • Phone: 413-437-9862
  • Fax: 413-437-9999
Mailing address:
  • Phone: 413-437-9862
  • Fax: 413-437-9999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number251E00000X
License Number StateMA

VIII. Authorized Official

Name: MRS. JUDITH A COTE
Title or Position: CEO
Credential:
Phone: 413-437-9862