Healthcare Provider Details

I. General information

NPI: 1992329817
Provider Name (Legal Business Name): DECEMBER CARES MULTISERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2020
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 MONTELLO ST APT 104
BROCKTON MA
02301-4096
US

IV. Provider business mailing address

124 MONTELLO ST APT 104
BROCKTON MA
02301-4096
US

V. Phone/Fax

Practice location:
  • Phone: 774-506-2168
  • Fax:
Mailing address:
  • Phone: 774-506-2168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: GREGORY VICTORIA
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 774-506-2168