Healthcare Provider Details

I. General information

NPI: 1245414721
Provider Name (Legal Business Name): CAREGIVER HOMES OF MASSACHUSETTS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2007
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 MIDSTATE DR STE 22
AUBURN MA
01501-1886
US

IV. Provider business mailing address

11 MIDSTATE DR STE 22
AUBURN MA
01501-1886
US

V. Phone/Fax

Practice location:
  • Phone: 617-797-0673
  • Fax: 617-236-7777
Mailing address:
  • Phone: 617-797-0673
  • Fax: 617-236-7777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: AMY SMITH
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 617-797-0673