Healthcare Provider Details

I. General information

NPI: 1841084910
Provider Name (Legal Business Name): NTERYCARE HOME HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2025
Last Update Date: 04/05/2025
Certification Date: 04/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 PINE ST
BROCKTON MA
02302-3616
US

IV. Provider business mailing address

20 ROCHE BROTHERS WAY UNIT 6272
NORTH EASTON MA
02356-1030
US

V. Phone/Fax

Practice location:
  • Phone: 508-586-0491
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: DIARRY SISSOKHO
Title or Position: FOUNDER/ OWNER
Credential: RN
Phone: 508-930-9083