Provider Demographics
NPI:1043336357
Name:HEARTH, INC.
Entity type:Organization
Organization Name:HEARTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-251-8318
Mailing Address - Street 1:1640 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-3380
Mailing Address - Country:US
Mailing Address - Phone:617-369-1557
Mailing Address - Fax:617-369-1566
Practice Address - Street 1:1640 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-3380
Practice Address - Country:US
Practice Address - Phone:617-369-1550
Practice Address - Fax:617-369-1566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1902598Medicaid
MA110032708AOtherPID-SL STATE ID