Provider Demographics
NPI:1902343866
Name:AGEWELL, LLC
Entity Type:Organization
Organization Name:AGEWELL, LLC
Other - Org Name:HOME HELPERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER & PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-545-0164
Mailing Address - Street 1:260 BOSTON POST RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:WAYLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01778-1889
Mailing Address - Country:US
Mailing Address - Phone:508-545-0164
Mailing Address - Fax:
Practice Address - Street 1:260 BOSTON POST RD
Practice Address - Street 2:SUITE 9
Practice Address - City:WAYLAND
Practice Address - State:MA
Practice Address - Zip Code:01778-1889
Practice Address - Country:US
Practice Address - Phone:508-545-0164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health