Healthcare Provider Details

I. General information

NPI: 1427772839
Provider Name (Legal Business Name): RESOLUTION HEALTHCARE GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2022
Last Update Date: 09/29/2022
Certification Date: 09/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 BARRY RD
WORCESTER MA
01609-1140
US

IV. Provider business mailing address

79 BARRY RD
WORCESTER MA
01609-1140
US

V. Phone/Fax

Practice location:
  • Phone: 508-667-7505
  • Fax:
Mailing address:
  • Phone: 508-667-7505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: STELLA KIMAKU
Title or Position: CEO
Credential:
Phone: 508-667-7505