Provider Demographics
NPI:1033542436
Name:VISITING NURSE ASSOCIATION OF SOUTHERN WORCESTER COUNTY INC.
Entity Type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF SOUTHERN WORCESTER COUNTY INC.
Other - Org Name:CENTRAL MA HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JACKLYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-943-0612
Mailing Address - Street 1:534 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01570-4319
Mailing Address - Country:US
Mailing Address - Phone:508-943-0612
Mailing Address - Fax:508-949-1476
Practice Address - Street 1:191 PAKACHOAG ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-2567
Practice Address - Country:US
Practice Address - Phone:508-755-4500
Practice Address - Fax:508-755-4588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7TJZ251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based