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General NPI Number Information
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NPI Number | 1588660443
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Entity Type | Organization
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Legal Business Name | VINEYARD NURSING ASSOCIATION, INC.
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Dates
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Enumeration Date | 06/24/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1 HOSPITAL ROAD
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City | OAK BLUFFS
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State | MA
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Zip | 02557-2568
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Country | US
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Telephone | 508-693-6184
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Fax | 508-693-5607
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Provider Business Mailing Address
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Address Line | PO BOX 2568
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City | OAK BLUFFS
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State | MA
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Zip | 02557-2568
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Country | US
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Telephone | 508-693-6184
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Fax | 508-693-5607
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. KATHLEEN F. ROSE
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Credential | RN, MHSA
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Telephone | 508-693-6184
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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 | 227233
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License Number State | MA
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