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General NPI Number Information
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NPI Number | 1225727654
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Entity Type | Organization
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Legal Business Name | BLACKWOOD HEALTH LLC
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Dates
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Enumeration Date | 05/02/2023
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Last Update Date | 05/02/2023
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Provider Practice Location Address
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Address Line | 13 WIGGIN AVE
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City | DEDHAM
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State | MA
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Zip | 02026-1600
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Country | US
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Telephone | 888-479-7699
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Fax | 781-471-7915
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Provider Business Mailing Address
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Address Line | 13 WIGGIN AVE
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City | DEDHAM
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State | MA
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Zip | 02026-1600
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Country | US
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Telephone | 888-479-7699
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | SANDRA ATELENE BLACKWOOD
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Credential | RN.BSN
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Telephone | 617-519-0651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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