Provider Demographics
NPI:1437770278
Name:AWESAM HOME HEALTH LLC
Entity Type:Organization
Organization Name:AWESAM HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANA
Authorized Official - Middle Name:ACHIAA
Authorized Official - Last Name:SAM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:774-240-1723
Mailing Address - Street 1:PO BOX 327
Mailing Address - Street 2:
Mailing Address - City:NORTHBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01534-0327
Mailing Address - Country:US
Mailing Address - Phone:484-424-2383
Mailing Address - Fax:
Practice Address - Street 1:84 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:NORTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01534-0153
Practice Address - Country:US
Practice Address - Phone:484-424-2383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-04
Last Update Date:2020-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty