Provider Demographics
NPI:1083199749
Name:NEW ENGLAND HOSPICE
Entity Type:Organization
Organization Name:NEW ENGLAND HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MSW
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGOS
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:774-573-5227
Mailing Address - Street 1:65 KINGLAND RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:MA
Mailing Address - Zip Code:01775-1510
Mailing Address - Country:US
Mailing Address - Phone:774-573-5227
Mailing Address - Fax:
Practice Address - Street 1:190 OLD DERBY ST STE 304
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-4065
Practice Address - Country:US
Practice Address - Phone:781-749-2900
Practice Address - Fax:781-749-2950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0609510Medicaid