Healthcare Provider Details

I. General information

NPI: 1245752633
Provider Name (Legal Business Name): GOLDEN YEARS HOME CARE SERVICES OF MASSACHUSETTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2017
Last Update Date: 10/06/2022
Certification Date: 10/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 SHAKER RD
EAST LONGMEADOW MA
01028-2731
US

IV. Provider business mailing address

16 SHAKER RD
EAST LONGMEADOW MA
01028-2731
US

V. Phone/Fax

Practice location:
  • Phone: 413-209-8208
  • Fax: 413-570-7252
Mailing address:
  • Phone: 413-209-8208
  • Fax: 413-570-7252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateMA

VIII. Authorized Official

Name: MR. CESAR RUIZ
Title or Position: PRESIDENT/CEO
Credential:
Phone: 413-209-8208