Provider Demographics
NPI:1417377078
Name:XANADU HOME HEALTH LLC
Entity Type:Organization
Organization Name:XANADU HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CCO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLIOTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-813-9994
Mailing Address - Street 1:12 WINTERBERRY HILL LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-1076
Mailing Address - Country:US
Mailing Address - Phone:508-813-9994
Mailing Address - Fax:
Practice Address - Street 1:12 WINTERBERRY HILL LN
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-1076
Practice Address - Country:US
Practice Address - Phone:508-813-9994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:XANADU HOME HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-22
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health