Healthcare Provider Details

I. General information

NPI: 1891611778
Provider Name (Legal Business Name): MHWC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 HILL CREEK RD
CENTERVILLE MA
02632-3365
US

IV. Provider business mailing address

16 HILL CREEK RD
CENTERVILLE MA
02632-3365
US

V. Phone/Fax

Practice location:
  • Phone: 508-292-4270
  • Fax: 508-978-8144
Mailing address:
  • Phone: 508-292-4270
  • Fax: 508-978-8144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIEL LUCZKOW
Title or Position: OWNER
Credential: MD
Phone: 508-292-4270