Provider Demographics
NPI:1881092732
Name:PLANET HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:PLANET HOME HEALTH CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEEQO
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-888-7910
Mailing Address - Street 1:423 BROOKLINE AVE
Mailing Address - Street 2:104
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5410
Mailing Address - Country:US
Mailing Address - Phone:617-888-7910
Mailing Address - Fax:
Practice Address - Street 1:423 BROOKLINE AVE
Practice Address - Street 2:104
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5410
Practice Address - Country:US
Practice Address - Phone:617-888-7910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AT MARTIN HOMECARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health