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General NPI Number Information
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NPI Number | 1215736723
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Entity Type | Organization
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Legal Business Name | EL HADDIS HOME HEALTHCARE AGENCY,LLC
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 769 CENTER STREET JAMAICA PLAIN
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City | BOSTON
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State | MA
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Zip | 02130
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Country | US
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Telephone | 617-906-3488
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Fax | 888-649-5028
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Provider Business Mailing Address
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Address Line | 771 BOSTON POST RD STE 11 # 1065
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City | MARLBOROUGH
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State | MA
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Zip | 01752
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Country | US
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Telephone | 617-906-8834
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Fax | 888-649-5028
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Authorized Official
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Title or Position | OWNER
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Name | EDWIGE S LABASTILLE
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Credential |
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Telephone | 857-544-6636
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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 |
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License Number State |
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