Provider Demographics
NPI:1831482504
Name:EZ HEALTHCARE OF BOSTON GROUP, INC
Entity Type:Organization
Organization Name:EZ HEALTHCARE OF BOSTON GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CUTHBERT
Authorized Official - Middle Name:IVAN
Authorized Official - Last Name:MAYERS
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN,MBA
Authorized Official - Phone:617-947-3311
Mailing Address - Street 1:73 CEDAR STREET
Mailing Address - Street 2:
Mailing Address - City:ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02119-1428
Mailing Address - Country:US
Mailing Address - Phone:617-433-2993
Mailing Address - Fax:617-442-0377
Practice Address - Street 1:85 ALEXANDER ST
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02125-2727
Practice Address - Country:US
Practice Address - Phone:617-947-3311
Practice Address - Fax:617-442-0377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-27
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8009251E00000X
MAT608251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health