Provider Demographics
NPI:1679168355
Name:MASONICARE HOME HEALTH AND HOSPICE, INC.
Entity Type:Organization
Organization Name:MASONICARE HOME HEALTH AND HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:JON-PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:VENOIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-679-6000
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-7001
Mailing Address - Country:US
Mailing Address - Phone:203-678-7853
Mailing Address - Fax:
Practice Address - Street 1:81 BEACH ST
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-2784
Practice Address - Country:US
Practice Address - Phone:888-332-0033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MASONICARE HOME HEALTH AND HOSPICE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based