Healthcare Provider Details

I. General information

NPI: 1477965432
Provider Name (Legal Business Name): HARVEST HOME HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2014
Last Update Date: 05/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 MAIN ST SUITE ST 803
WORCESTER MA
01608-1604
US

IV. Provider business mailing address

340 MAIN ST SUITE ST 803
WORCESTER MA
01608-1604
US

V. Phone/Fax

Practice location:
  • Phone: 508-335-6595
  • Fax:
Mailing address:
  • Phone: 508-335-6595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JEFFREY ORTIZ
Title or Position: DIRECTOR
Credential:
Phone: 508-335-6595