=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275241341
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WASHINGTON HEALTHCARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/08/2022
-----------------------------------------------------
Last Update Date | 02/01/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5260 WASHINGTON ST STE 11
-----------------------------------------------------
City | WEST ROXBURY
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02132-6354
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-475-2400
-----------------------------------------------------
Fax | 800-546-2141
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5260 WASHINGTON ST STE 11
-----------------------------------------------------
City | WEST ROXBURY
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02132-6354
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-475-2400
-----------------------------------------------------
Fax | 800-546-2141
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF OPERATING OFFICER
-----------------------------------------------------
Name | MAXIME JOSEPH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 617-475-2400
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------