Healthcare Provider Details

I. General information

NPI: 1356201529
Provider Name (Legal Business Name): SHALOM HOMECARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2025
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 MAIN ST STE 200
CHARLESTOWN MA
02129-1119
US

IV. Provider business mailing address

14 SCHOOL ST
WESTBOROUGH MA
01581-2019
US

V. Phone/Fax

Practice location:
  • Phone: 800-708-5075
  • Fax: 508-366-6991
Mailing address:
  • Phone: 269-252-7624
  • Fax: 269-252-7624

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 Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SARAH NAKADDU
Title or Position: DIRECTOR
Credential:
Phone: 269-252-7624