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General NPI Number Information
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NPI Number | 1801601364
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Entity Type | Organization
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Legal Business Name | WALSH PCAH LLC
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 138 CHURCH ST APT 6
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City | BURLINGTON
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State | VT
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Zip | 05401-4450
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Country | US
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Telephone | 802-383-6333
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Fax |
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Provider Business Mailing Address
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Address Line | 49 ALLEN RD
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City | GEORGIA
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State | VT
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Zip | 05478-4497
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Country | US
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Telephone | 802-383-6333
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JUSTIN BALLARD
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Credential |
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Telephone | 802-383-6333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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