Provider Demographics
NPI:1124210141
Name:THE FITCH HOME, INC.
Entity Type:Organization
Organization Name:THE FITCH HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LESTER
Authorized Official - Middle Name:HN
Authorized Official - Last Name:BURNHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-665-0521
Mailing Address - Street 1:75 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-2701
Mailing Address - Country:US
Mailing Address - Phone:781-665-0521
Mailing Address - Fax:781-665-2359
Practice Address - Street 1:75 LAKE AVE
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-2701
Practice Address - Country:US
Practice Address - Phone:781-665-0521
Practice Address - Fax:781-665-2359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home