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General NPI Number Information
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NPI Number | 1417225392
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Entity Type | Organization
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Legal Business Name | WELL AT HOME CARE
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Dates
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Enumeration Date | 12/07/2011
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Last Update Date | 12/07/2011
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Provider Practice Location Address
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Address Line | 24 OAKLEY ST
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City | DORCHESTER CENTER
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State | MA
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Zip | 02124-1014
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Country | US
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Telephone | 888-673-9904
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Fax |
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Provider Business Mailing Address
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Address Line | 24 OAKLEY ST
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City | DORCHESTER CENTER
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State | MA
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Zip | 02124-1014
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Country | US
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Telephone | 888-673-9904
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. NATASHA JOHNSON
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Credential | LPN
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Telephone | 617-828-7911
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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 | MA
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