Provider Demographics
NPI:1760866065
Name:MASS GENERAL BRIGHAM HOME CARE, INC.
Entity Type:Organization
Organization Name:MASS GENERAL BRIGHAM HOME CARE, INC.
Other - Org Name:PARTNERS HEALTHCARE AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT AND COO
Authorized Official - Prefix:
Authorized Official - First Name:KEREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-290-4000
Mailing Address - Street 1:95 WELLS AVE STE 320
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-3216
Mailing Address - Country:US
Mailing Address - Phone:781-290-4000
Mailing Address - Fax:781-290-4050
Practice Address - Street 1:95 WELLS AVE STE 320
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02459-3216
Practice Address - Country:US
Practice Address - Phone:781-290-4000
Practice Address - Fax:781-290-4050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-16
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty