Healthcare Provider Details

I. General information

NPI: 1124855374
Provider Name (Legal Business Name): OBIDIENT HOME HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2024
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

478 TORREY ST STE 5
BROCKTON MA
02301-4696
US

IV. Provider business mailing address

748 COURT ST
BROCKTON MA
02302-2870
US

V. Phone/Fax

Practice location:
  • Phone: 617-510-6963
  • Fax:
Mailing address:
  • Phone: 617-510-6963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. ESTHER ONOCHIE
Title or Position: CEO
Credential: RN MSN
Phone: 615-510-6963