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General NPI Number Information
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NPI Number | 1225312036
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Entity Type | Organization
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Legal Business Name | EDGE LIFE HEALTHCARE INC.
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Dates
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Enumeration Date | 09/29/2011
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Last Update Date | 12/02/2014
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Provider Practice Location Address
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Address Line | 15 NEW ENGLAND EXECUTIVE PARK
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City | BURLINGTON
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State | MA
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Zip | 01803-5202
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Country | US
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Telephone | 857-524-5122
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Fax |
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Provider Business Mailing Address
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Address Line | 54 CUMMINGS PARK STE 306
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City | WOBURN
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State | MA
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Zip | 01801-2192
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Country | US
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Telephone | 857-524-5122
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | BABU R MAHARJAN
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Credential |
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Telephone | 857-524-5122
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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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