Provider Demographics
NPI:1083644017
Name:MASS GENERAL BRIGHAM HOME CARE, INC.
Entity Type:Organization
Organization Name:MASS GENERAL BRIGHAM HOME CARE, INC.
Other - Org Name:PARTNERS HEALTHCARE AT HOME - HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT AND COO
Authorized Official - Prefix:
Authorized Official - First Name:KEREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-290-4000
Mailing Address - Street 1:95 WELLS AVE STE 320
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-3216
Mailing Address - Country:US
Mailing Address - Phone:781-290-4000
Mailing Address - Fax:781-290-4050
Practice Address - Street 1:95 WELLS AVE STE 320
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-3216
Practice Address - Country:US
Practice Address - Phone:781-290-4000
Practice Address - Fax:781-290-4050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0020564OtherNEIGHBORHOOD HEALTH PLAN
MA0600008Medicaid
MA0000120207OtherBLUE CROSS OF MA
MA702255OtherHARVARD PILGRIM
MA996197OtherNETWORK HEALTH
MA702255OtherHARVARD PILGRIM