Provider Demographics
NPI:1013444827
Name:BACK BAY HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:BACK BAY HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SANTO
Authorized Official - Middle Name:A
Authorized Official - Last Name:INSOLIA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:617-688-7549
Mailing Address - Street 1:80 BROAD ST
Mailing Address - Street 2:PH 1101
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02110-3522
Mailing Address - Country:US
Mailing Address - Phone:617-688-7549
Mailing Address - Fax:
Practice Address - Street 1:80 BROAD ST
Practice Address - Street 2:PH 1101
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02110-3522
Practice Address - Country:US
Practice Address - Phone:617-688-7549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health