Provider Demographics
NPI:1801601364
Name:WALSH PCAH LLC
Entity type:Organization
Organization Name:WALSH PCAH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-383-6333
Mailing Address - Street 1:49 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:GEORGIA
Mailing Address - State:VT
Mailing Address - Zip Code:05478-4497
Mailing Address - Country:US
Mailing Address - Phone:802-383-6333
Mailing Address - Fax:
Practice Address - Street 1:138 CHURCH ST APT 6
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4450
Practice Address - Country:US
Practice Address - Phone:802-383-6333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care