Provider Demographics
NPI:1083065908
Name:WACHUSETT VENTURES LLC
Entity Type:Organization
Organization Name:WACHUSETT VENTURES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:A
Authorized Official - Last Name:DENNEHY
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:978-464-7729
Mailing Address - Street 1:36 WASHINGTON ST
Mailing Address - Street 2:SUITE 190
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481-1900
Mailing Address - Country:US
Mailing Address - Phone:978-464-7729
Mailing Address - Fax:
Practice Address - Street 1:36 WASHINGTON ST
Practice Address - Street 2:SUITE 190
Practice Address - City:WELLESLEY HILLS
Practice Address - State:MA
Practice Address - Zip Code:02481-1900
Practice Address - Country:US
Practice Address - Phone:978-464-7729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility