Provider Demographics
NPI:1639465602
Name:LEE REGIONAL VISITING NURSE ASSOCIATION, INC
Entity Type:Organization
Organization Name:LEE REGIONAL VISITING NURSE ASSOCIATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CHAFFEE
Authorized Official - Suffix:
Authorized Official - Credentials:RN,MSN
Authorized Official - Phone:413-243-1212
Mailing Address - Street 1:32 PARK ST
Mailing Address - Street 2:
Mailing Address - City:LEE
Mailing Address - State:MA
Mailing Address - Zip Code:01238-1717
Mailing Address - Country:US
Mailing Address - Phone:413-243-1212
Mailing Address - Fax:413-243-4215
Practice Address - Street 1:32 PARK ST
Practice Address - Street 2:
Practice Address - City:LEE
Practice Address - State:MA
Practice Address - Zip Code:01238-1717
Practice Address - Country:US
Practice Address - Phone:413-243-1212
Practice Address - Fax:413-243-4215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty