Provider Demographics
NPI:1053873547
Name:AWENASA HOME INC.
Entity type:Organization
Organization Name:AWENASA HOME INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HEMANTH
Authorized Official - Middle Name:
Authorized Official - Last Name:HARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:857-891-0700
Mailing Address - Street 1:26 INMAN ST. #GD
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139
Mailing Address - Country:US
Mailing Address - Phone:857-891-0700
Mailing Address - Fax:
Practice Address - Street 1:71 UNION ST.
Practice Address - Street 2:WILLOWBROOK MANOR REST HOME
Practice Address - City:MILLIS
Practice Address - State:MA
Practice Address - Zip Code:02054
Practice Address - Country:US
Practice Address - Phone:508-376-5083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility