Healthcare Provider Details

I. General information

NPI: 1336234830
Provider Name (Legal Business Name): INTERCARE GROUP INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 JEFFREY'S NECK ROAD
IPSWICH MA
01938
US

IV. Provider business mailing address

20 CABOT BLVD SUITE 300
MANSFIELD MA
02048
US

V. Phone/Fax

Practice location:
  • Phone: 978-356-4381
  • Fax:
Mailing address:
  • Phone: 508-622-0186
  • Fax: 610-552-9807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. RITA KELLEHER
Title or Position: VICE PRESIDENT
Credential:
Phone: 508-622-0186