Provider Demographics
NPI:1558477836
Name:EPOCH SLV LLL
Entity Type:Organization
Organization Name:EPOCH SLV LLL
Other - Org Name:EPOCH HOSPICE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:
Authorized Official - Last Name:PFAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-891-0777
Mailing Address - Street 1:51 SAWYER RD
Mailing Address - Street 2:STE 500
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453
Mailing Address - Country:US
Mailing Address - Phone:781-810-1240
Mailing Address - Fax:781-647-0697
Practice Address - Street 1:615 HEATH STREET
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02067
Practice Address - Country:US
Practice Address - Phone:617-232-0445
Practice Address - Fax:617-232-3743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0609391Medicaid
MA221568Medicare Oscar/Certification