Healthcare Provider Details

I. General information

NPI: 1366825374
Provider Name (Legal Business Name): HUMBLE CARE GIVERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2015
Last Update Date: 07/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 RIVER STREET PLACE
LYNN MA
01905
US

IV. Provider business mailing address

15 RIVER STREET PLACE
LYNN MA
01905
US

V. Phone/Fax

Practice location:
  • Phone: 781-513-6564
  • Fax:
Mailing address:
  • Phone: 781-513-6564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: BRIDGET NAMBOUH
Title or Position: CEO
Credential:
Phone: 781-513-6564