Provider Demographics
NPI:1932434263
Name:HENRY C. NEVINS HOME FOR THE AGED & INCUBABLE, INC
Entity Type:Organization
Organization Name:HENRY C. NEVINS HOME FOR THE AGED & INCUBABLE, INC
Other - Org Name:TRANS CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCIAL ANALYST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:A
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-682-7611
Mailing Address - Street 1:12 INGALLS CT
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-3712
Mailing Address - Country:US
Mailing Address - Phone:978-682-7611
Mailing Address - Fax:978-794-0279
Practice Address - Street 1:12 INGALLS CT
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-3712
Practice Address - Country:US
Practice Address - Phone:978-682-7611
Practice Address - Fax:978-794-0279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110031062AMedicaid
MA1711814Medicaid