Provider Demographics
NPI:1689703068
Name:NOTRE DAME HEALTH CARE CENTER, INC.
Entity Type:Organization
Organization Name:NOTRE DAME HEALTH CARE CENTER, INC.
Other - Org Name:NOTRE DAME HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGANELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-852-5505
Mailing Address - Street 1:555 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2376
Mailing Address - Country:US
Mailing Address - Phone:508-852-5505
Mailing Address - Fax:
Practice Address - Street 1:555 PLANTATION ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2376
Practice Address - Country:US
Practice Address - Phone:508-852-5505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-03
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2081H0002X
MA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081H0002XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationHospice and Palliative MedicineGroup - Multi-Specialty
No251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0608602Medicaid
221575Medicare Oscar/Certification