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General NPI Number Information
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NPI Number | 1104937697
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Entity Type | Organization
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Legal Business Name | SOUTHCOAST VISITING NURSE ASSOCIATION. INC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 200 MILL ROAD, SUITE 120
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City | FAIRHAVEN
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State | MA
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Zip | 02719
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Country | US
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Telephone | 508-973-3210
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Fax | 508-973-3215
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Provider Business Mailing Address
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Address Line | 200 MILL RD STE 120
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City | FAIRHAVEN
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State | MA
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Zip | 02719-5252
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Country | US
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Telephone | 508-973-3200
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Fax | 508-973-3215
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | FERNANDA JOHNSON
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Credential | PT, DPT
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Telephone | 508-973-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 2211
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License Number State | RI
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