Provider Demographics
NPI:1841520368
Name:BOSTON HOME HEALTH AIDES LLC
Entity type:Organization
Organization Name:BOSTON HOME HEALTH AIDES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMA
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:617-264-0200
Mailing Address - Street 1:1 UNION STREET
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01840-1835
Mailing Address - Country:US
Mailing Address - Phone:617-264-0200
Mailing Address - Fax:617-264-0610
Practice Address - Street 1:1 UNION STREET
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01840-1835
Practice Address - Country:US
Practice Address - Phone:617-264-0200
Practice Address - Fax:617-264-0610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-05
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110088132AMedicaid
MA227524Medicare Oscar/Certification