Healthcare Provider Details

I. General information

NPI: 1801135058
Provider Name (Legal Business Name): BORDEN CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2013
Last Update Date: 02/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 JACKSON ST
FALL RIVER MA
02721-3712
US

IV. Provider business mailing address

176 JACKSON ST
FALL RIVER MA
02721
US

V. Phone/Fax

Practice location:
  • Phone: 508-982-9211
  • Fax:
Mailing address:
  • Phone: 508-982-9211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number15922
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: TAMMY PEREIRA
Title or Position: RN
Credential: RN
Phone: 508-982-9211