Provider Demographics
NPI:1417159153
Name:EASTERN ORTHODOX MANAGEMENT CORP.
Entity Type:Organization
Organization Name:EASTERN ORTHODOX MANAGEMENT CORP.
Other - Org Name:D/B/A HOLY TRINITY HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:M
Authorized Official - Last Name:LAGANELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-852-1000
Mailing Address - Street 1:300 BARBER AVENUE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2467
Mailing Address - Country:US
Mailing Address - Phone:508-852-1000
Mailing Address - Fax:508-854-1622
Practice Address - Street 1:1183 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01603-2012
Practice Address - Country:US
Practice Address - Phone:508-791-8200
Practice Address - Fax:508-791-8205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251G0000X251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based