Provider Demographics
NPI:1700871092
Name:HOLYOKE VISITING NURSE ASSOCIATION, INC.
Entity Type:Organization
Organization Name:HOLYOKE VISITING NURSE ASSOCIATION, INC.
Other - Org Name:HOLYOKE VNA & HOSPICE LIFE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:413-534-5691
Mailing Address - Street 1:575 BEECH STREET
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-2223
Mailing Address - Country:US
Mailing Address - Phone:413-534-5691
Mailing Address - Fax:413-538-7168
Practice Address - Street 1:10 HOSPITAL DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-6603
Practice Address - Country:US
Practice Address - Phone:413-534-5691
Practice Address - Fax:413-538-7168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-13
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA120015OtherBLUE SHIELD
MA0602302Medicaid
MA120015OtherBLUE SHIELD