Healthcare Provider Details

I. General information

NPI: 1336675263
Provider Name (Legal Business Name): WEST RIVER HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 WELLS AVE STE 20
NEWTON MA
02459-3227
US

IV. Provider business mailing address

57 WELLS AVE STE 20
NEWTON MA
02459-3227
US

V. Phone/Fax

Practice location:
  • Phone: 781-707-9000
  • Fax: 781-281-8457
Mailing address:
  • Phone: 781-707-9000
  • Fax: 781-281-8457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number7J02
License Number StateMA

VIII. Authorized Official

Name: KALI HART
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 781-707-9578