Healthcare Provider Details

I. General information

NPI: 1578476222
Provider Name (Legal Business Name): MAUSE HOME & COMMUNITY HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 DAN RD STE 125
CANTON MA
02021-2860
US

IV. Provider business mailing address

45 DAN RD STE 125
CANTON MA
02021-2860
US

V. Phone/Fax

Practice location:
  • Phone: 781-577-0505
  • Fax:
Mailing address:
  • Phone: 781-577-0505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MRS. BILIKISU ODUFUYE-GANDONU
Title or Position: CEO
Credential:
Phone: 781-577-0505